Lingegowda Jyothi B, MuddeGowda Prakash H, Ramakantha Chatura K, Chandrasekar H R
Department of Pathology, VMKV Medical College, Salem, Tamil Nadu, India.
Diagn Cytopathol. 2011 Apr;39(4):251-7. doi: 10.1002/dc.21374.
Assigning a tumor grade to breast cancer provides important prognostic information and guides optimal therapy. The present study was undertaken to grade breast carcinoma on aspirates by Robinson grading (RGS) and Scarff-Bloom-Richardson grading system (SBR). Histological grading was done according to Nottingham modification of Scarff-Bloom-Richardson method and the two cytological grading systems were compared. Fifty cases of breast carcinoma with preoperative cytologic diagnosis were assigned tumor grade. Histologic grading was done on corresponding mastectomy or partially resected specimens. Statistical analysis was performed; correlation between cytologic and histologic grading was established using Spearman correlation coefficient. Regression analysis was done to assess the significance of each cytological feature. Univariate analysis showed strong correlation (P < 0.01) for all features except dissociation. Multiple regression analysis of cytologic features revealed cell dissociation nucleoli and nuclear margin as the most influential features. A concordance of 72.5% between RGS (cyto) and SBR (cyto), 64% for RGS (cyto) and SBR (histo), 82% for SBR (cyto) and SBR (histo) was noted. There was a significant association (P < 0.001) between the grades assigned to cytologic and histologic specimens. Cytologic grade could be used to predict histologic grade as significant relationship exists between grades assigned to cytologic and histologic specimens.
对乳腺癌进行肿瘤分级可提供重要的预后信息并指导最佳治疗。本研究旨在通过罗宾逊分级系统(RGS)和斯卡夫-布卢姆-理查森分级系统(SBR)对乳腺吸出物中的乳腺癌进行分级。组织学分级按照斯卡夫-布卢姆-理查森方法的诺丁汉改良版进行,并对两种细胞学分级系统进行比较。对50例术前经细胞学诊断的乳腺癌病例进行肿瘤分级。对相应的乳房切除术或部分切除标本进行组织学分级。进行了统计分析;使用斯皮尔曼相关系数确定细胞学分级与组织学分级之间的相关性。进行回归分析以评估每个细胞学特征的重要性。单因素分析显示,除细胞解离外,所有特征均具有强相关性(P < 0.01)。对细胞学特征的多元回归分析显示,细胞解离、核仁和核边缘是最具影响力的特征。RGS(细胞学)与SBR(细胞学)之间的一致性为72.5%,RGS(细胞学)与SBR(组织学)之间为64%,SBR(细胞学)与SBR(组织学)之间为82%。细胞学标本和组织学标本的分级之间存在显著关联(P < 0.001)。由于细胞学标本和组织学标本的分级之间存在显著关系,因此细胞学分级可用于预测组织学分级。