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Nuclear Grade Plus Proliferation Grading System for Invasive Ductal Carcinoma of the Breast: Validation in a Tertiary Referral Hospital Cohort.

乳腺浸润性导管癌N+P分级系统：在三级转诊体系中得到验证

Papadimitriou M,Kaptanis S,Polymeropoulos E,Mitsopoulos G,Stogiannis D,Caroni C,Vaiopoulos G,Panayiotides JG,Karakitsos P
阅读：1252 American Journal of Clinical Pathology； December; 144 (6) : 828 - 959:837-43 

Abstract

For patients with invasive breast cancer, management decisions are informed by tumor grade according to the Nottingham Grading System (NGS), either on its own or as part of the Nottingham Prognostic Index (NPI). A system retaining the nuclear grade element but substituting the two subjective components, mitosis count and tubule formation, of the NGS with a proliferation index based on Ki-67 (MIB-1) has been proposed (nuclear grade plus proliferation [N+P] grading).
We validated the prognostic value of this grading system on a population of 322 women.
N+P grading resulted in more grade I tumors (47.9% vs 4.5%) and fewer grade II (32% vs 51.5%) and grade III (20.1% vs 44%) tumors compared with NGS. The NPI calculated based on N+P grade had a similar association with survival (P < .001; odds ratio, 1.729) as the NPI calculated on the basis of the NGS grade (P < .001; odds ratio, 1.668).
The N+P system seems equivalent to the NGS system.

摘要

对于浸润性乳腺癌患者来讲，治疗决策是根据诺丁汉分级系统（NGS）中肿瘤的分级以及完全或部分的诺丁汉预后指数（NPI）来制定的。最近提出了一种新的分级系统，即细胞核级别加增殖指数[N+P]分级系统，其保留了细胞核级别要素，但是采用基于Ki-67（MIB-1）的增殖指数取代了NGS中另外两个主要因素（即核分裂数和小管形成）。我们在322例的女性人群中验证了这一分级系统的预后价值。与NGS分级系统相比，N+P分级系统的结果中含有较多的I级肿瘤（47.9% vs 4.5%）和较少的II级（32% vs 51.5%）及III级（20.1% vs 44%）肿瘤。基于N+P分级系统计算的NIP与存活率之间的关系（P < 0.001，优势比=1.729）与基于NGS分级系统计算的NIP与存活率之间的关系（P < 0.001，优势比=1.668）相似。N+P分级系统与NGS系统具有同等的应用价值。


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