Pathological evaluation of tumor grade for salivary adenoid cystic carcinoma: A proposal of an objective grading system

被引：21

作者：

Morita, Naruhiko ^{[1
,2
]}

Murase, Takayuki ^{[1
]}

Ueda, Kaori ^{[1
,3
]}

Nagao, Toshitaka ^{[4
]}

Kusafuka, Kimihide ^{[5
]}

Nakaguro, Masato ^{[6
]}

Urano, Makoto ^{[7
]}

Taguchi, Ken-ichi ^{[8
]}

Yamamoto, Hidetaka ^{[9
]}

Kano, Satoshi ^{[10
,11
]}

Tada, Yuichiro ^{[12
]}

Tsukahara, Kiyoaki ^{[13
]}

Okami, Kenji ^{[14
]}

Onitsuka, Tetsuro ^{[15
]}

Fujimoto, Yasushi ^{[16
]}

Kawakita, Daisuke ^{[17
]}

Sakurai, Kazuo ^{[18
]}

Nagao, Toru ^{[3
]}

Hanai, Nobuhiro ^{[19
]}

Kawata, Ryo ^{[20
]}

Hato, Naohito ^{[21
]}

Otsuki, Naoki ^{[2
]}

Nibu, Ken-ichi ^{[2
]}

Inagaki, Hiroshi ^{[1
]}

机构：

[1] Nagoya City Univ, Grad Sch Med Sci, Dept Pathol & Mol Diagnost, Nagoya, Aichi, Japan

[2] Kobe Univ, Grad Sch Med, Dept Otolaryngol Head & Neck Surg, Kobe, Hyogo, Japan

[3] Aichi Gakuin Univ, Sch Dent, Dept Maxillofacial Surg, Nisshin, Aichi, Japan

[4] Tokyo Med Univ, Sch Med, Dept Anat Pathol, Tokyo, Japan

[5] Shizuoka Prefectural Gen Hosp, Dept Pathol, Shizuoka, Japan

[6] Nagoya Univ Hosp, Dept Pathol & Lab Med, Nagoya, Aichi, Japan

[7] Fujita Hlth Univ, Dept Diagnost Pathol, Sch Med, Toyoake, Aichi, Japan

[8] Kyushu Canc Ctr, Natl Hosp Org, Dept Pathol, Fukuoka, Japan

[9] Kyushu Univ, Grad Sch Med Sci, Dept Anat Pathol, Fukuoka, Japan

[10] Hokkaido Univ, Fac Med, Dept Otolaryngol Head & Neck Surg, Sapporo, Hokkaido, Japan

[11] Hokkaido Univ, Grad Sch Med, Sapporo, Hokkaido, Japan

[12] Int Univ Hlth & Welf, Mita Hosp, Dept Head & Neck Oncol & Surg, Tokyo, Japan

[13] Tokyo Med Univ, Dept Otorhinolaryngol Head & Neck Surg, Tokyo, Japan

[14] Tokai Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, Hiratsuka, Kanagawa, Japan

[15] Shizuoka Canc Ctr, Div Head & Neck Surg, Shizuoka, Japan

[16] Aichi Med Univ, Dept Otorhinolaryngol, Nagakute, Aichi, Japan

[17] Nagoya City Univ, Grad Sch Med Sci, Dept Otorhinolaryngol Head & Neck Surg, Nagoya, Aichi, Japan

[18] Fujita Hlth Univ, Okazaki Med Ctr, Dept Otorhinolaryngol, Toyoake, Aichi, Japan

[19] Aichi Canc Ctr Hosp, Dept Head & Neck Surg, Nagoya, Aichi, Japan

[20] Osaka Med Coll, Dept Otorhinolaryngol Head & Neck Surg, Osaka, Japan

[21] Ehime Univ, Sch Med, Dept Otolaryngol, Matsuyama, Ehime, Japan

来源：

CANCER SCIENCE | 2021年 / 112卷 / 03期

关键词：

adenoid cystic carcinoma; interobserver variability; pathological grading system; prognosis; salivary gland;

D O I：

10.1111/cas.14790

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Three pathological grading systems advocated by Perzin/Szanto, Spiro, and van Weert are currently used for adenoid cystic carcinoma (AdCC). In these systems, the amount or presence of the solid tumor component in AdCC specimens is an important index. However, the "solid tumor component" has not been well defined. Salivary AdCC cases (N = 195) were collected after a central pathology review. We introduced a novel criterion for solid tumor component, minAmax (minor axis maximum). The largest solid tumor nest in each AdCC case was histologically screened, the maximum oval fitting the solid nest was estimated, and the length of the minor axis of the oval (minAmax) was measured. The prognostic cutoff for the minAmax was determined using training and validation cohorts. All cases were evaluated for the four grading systems, and their prognostic impact and interobserver variability were examined. The cutoff value for the minAmax was set at 0.20 mm. Multivariate prognostic analyses showed the minAmax and van Weert systems to be independent prognostic tools for overall, disease-free, and distant metastasis-free survival while the Perzin/Szanto and Spiro systems were selected for overall survival but not for disease-free or distant metastasis-free survival. The highest hazard ratio for overall survival (11.9) was obtained with the minAmax system. The reproducibility of the minAmax system (kappa coefficient of 0.81) was scored as very good while those of the other three systems were scored as moderate. In conclusion, the minAmax is a simple, objective, and highly reproducible grading system useful for prognostic stratification for salivary AdCC.

引用

页码：1184 / 1195

页数：12

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