de Silva M V, Tilakaratna A D, Rodrigo T
Faculty of Medicine, University of Colombo.
Ceylon Med J. 1998 Dec;43(4):232-4.
Histologic grading of breast cancer is related to prognosis and management of patients. The grading systems used are the initially formulated subjective methods, and the more recently described objective Nottingham system. In Sri Lanka there is lack of uniformity in histopathology reporting of breast cancer. All methods used employ 3 grades. If histologic grading is to be of clinical relevance, it is important that the grades of different systems correlate with one another.
To determine if the three grades of the Nottingham system correlate with those of the other systems.
Department of Pathology, Faculty of Medicine, Colombo.
54 breast carcinomas were graded using the Nottingham system by reviewing histology slides. The Nottingham grading was compared with the original grading mentioned in the histology report.
The original reports included 35 tumours graded with systems other than Nottingham. 45.7% of these tumours did not correspond with the subsequent Nottingham grade. 40% had to be upgraded from grade II to III. When the 19 tumours originally graded using the Nottingham system were re-evaluated using the same system, there was concurrence in 89.5% of the cases.
Our results indicate a failure of other grading systems to correlate with the corresponding Nottingham grade in a high proportion of cases. We recommend the adoption of a single, objective grading system such as the Nottingham method by all clinicians in Sri Lanka.
乳腺癌的组织学分级与患者的预后及治疗相关。所使用的分级系统有最初制定的主观方法，以及最近描述的客观诺丁汉系统。在斯里兰卡，乳腺癌的组织病理学报告缺乏一致性。所有使用的方法都采用3级分级。如果组织学分级要具有临床相关性，那么不同系统的分级相互关联就很重要。
确定诺丁汉系统的3个分级是否与其他系统的分级相关。
科伦坡医学院病理科。
通过复查组织学切片，使用诺丁汉系统对54例乳腺癌进行分级。将诺丁汉分级与组织学报告中提到的原始分级进行比较。
原始报告中包括35例未使用诺丁汉系统分级的肿瘤。其中45.7%的肿瘤与随后的诺丁汉分级不相符。40%的肿瘤不得不从Ⅱ级升至Ⅲ级。当对最初使用诺丁汉系统分级的19例肿瘤用同一系统重新评估时，89.5%的病例结果一致。
我们的结果表明，在很大比例的病例中，其他分级系统与相应的诺丁汉分级不相关。我们建议斯里兰卡所有临床医生采用单一的客观分级系统，如诺丁汉方法。
