Adenocarcinoma predominant pattern subtyping and nuclear grading in cytology: Is there a role in prognostication of advanced pulmonary adenocarcinomas?
| Autor: | Karan Madan, Harpreet Kaur, Kirti Jangra, Kavneet Kaur, Deepali Jain, Aruna Nambirajan, Sandeep Mathur, V. K. Iyer |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Adult Male Pathology medicine.medical_specialty Histology Lung Neoplasms Adenocarcinoma of Lung Disease-Free Survival Pathology and Forensic Medicine 03 medical and health sciences 0302 clinical medicine Cytology Biopsy medicine Humans Nuclear grade Grading (tumors) Aged Retrospective Studies Aged 80 and over Lung medicine.diagnostic_test business.industry General Medicine Middle Aged medicine.disease Subtyping Survival Rate 030104 developmental biology medicine.anatomical_structure 030220 oncology & carcinogenesis Adenocarcinoma Female Neoplasm Grading business |
| Zdroj: | Cytopathology : official journal of the British Society for Clinical Cytology. 29(2) |
| ISSN: | 1365-2303 |
| Popis: | INTRODUCTION Primary lung adenocarcinomas (ADs) show varied architectural patterns, and pattern-based subtyping of ADs is currently recommended due to prognostic implications. Predicting AD patterns on cytology is challenging; however, cytological nuclear features appear to correlate with histological grade and survival in early stage lung ADs. The feasibility and value of AD pattern prediction and nuclear grading on cytology in advanced lung ADs is not known. We aimed to predict patterns and analyse nuclear features on cytology and evaluate their role in prognostication. METHODS One-hundred patients of Stage III/IV lung AD with available matched cytology and histology samples were included. Cyto-patterns based on cell arrangement patterns (flat sheets vs three-dimensional clusters vs papillae) and cyto-nuclear score based on nuclear features (size, shape, contour), nucleoli (macronucleoli vs prominent vs inconspicuous), and nuclear chromatin were determined, and correlated with predominant histological-pattern observed on the matched small biopsy and outcome. RESULTS Higher cyto-nuclear scores were observed with high-grade histo-patterns (solid, micropapillary and cribriform), while the predicted cyto-patterns did not correspond to the predominant pattern on histology in 77% cases. Highest cyto-histo agreement was observed for solid pattern (72%). High grade histo-patterns and cyto-nuclear scores > 3 showed a trend towards inferior survival (not significant). CONCLUSIONS Nuclear grade scoring on cytology is simple to perform, and is predictive of high grade patterns. Its inclusion in routine reporting of cytology samples of lung ADs may be valuable. |
| Databáze: | OpenAIRE |
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