Department of Pathology, University of Szeged, Szeged, Hungary.
Department of Pathology, Bács-Kiskun County Teaching Hospital, Kecskemét, Hungary.
Pathologica. 2024 Feb;116(1):22-31. doi: 10.32074/1591-951X-958.
To compare histological grade (G) of breast cancer and its components (scores for tubule formation - T, nuclear pleomorphism - P and mitotic counts - M) in core needle biopsies (CNBs) and surgical excision specimens (EXC) in patients treated with primary surgery (CHIR) or primary chemotherapy (PST).
Grade of matched pairs of carcinomas in CNB and EXC was assessed according to the Nottingham grading system.
PST cases tended to have higher pretreatment G. Concordance rates in the CHIR (n = 760) and PST (n = 148) groups for T, P, M and G were 79%, 70%, 75%, 71% and 77%, 70%, 50%, 62%, respectively; differences in concordance rates were significant in M (p < 0.0001) and G (p = 0.024). For discordant cases in the CHIR group, CNBs tended to overestimate T and underestimate P, M and G, whereas in the PST group, the same trends were identified for T and P, but there was a significant tendency for M and G to be lower in EXC specimens.
The reversal of M and G underestimation in CNB to "overestimation" in the PST group can only be explained with the effect of mitosis reduction following chemotherapy. Whether the posttreatment decrease in G reflects any prognostic value remains to be elucidated.
比较接受新辅助化疗（PST）或新辅助手术（CHIR）治疗的患者的核心针活检（CNB）和手术切除标本（EXC）中乳腺癌的组织学分级（G）及其成分（管腔形成评分-T、核异型性评分-P 和有丝分裂计数评分-M）。
根据 Nottingham 分级系统评估 CNB 和 EXC 中配对癌的分级。
PST 病例在预处理时 G 级较高。CHIR 组（n = 760）和 PST 组（n = 148）中 T、P、M 和 G 的一致性率分别为 79%、70%、75%、71%和 77%、70%、50%、62%；在 M（p < 0.0001）和 G（p = 0.024）方面，一致性率存在显著差异。在 CHIR 组中不一致的病例中，CNB 倾向于高估 T 而低估 P、M 和 G，而在 PST 组中，T 和 P 也存在同样的趋势，但在 EXC 标本中，M 和 G 显著偏低。
仅能通过化疗后有丝分裂减少的作用来解释 PST 组中 CNB 中 M 和 G 低估向“高估”的逆转。G 级治疗后下降是否反映任何预后价值仍有待阐明。
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