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Dzien dobry!
Dzis moja mama odebrala wyniki Biopsji,do lekarza idzie dopiero za tydzien,a my kompletnie nie wiemy jak je odczytac,moze ktos z was umialby to zrobic,bede bardzo wdzieczna.Oto one:
NHG 2(3+2+1:2)mitozy/10 HPF srednia pola 0,55mm.
Troche mnie to dziwi bo w internecie znalazlam jakies oznaczenia;ER,PGR a tu takiego czegos nie ma.

NHG to Nottingham Histologic Grading (zmodyfikowany system Elston-Ellis) - system okreslania prognozy dla raka piersi preferowany obecnie w Europie.

Histological Grading of Breast Cancer

NOTTINGHAM GRADING SYSTEM

Within the last decade, histologic grading has become widely accepted as a powerful indicator of prognosis in breast cancer. The majority of tumor grading systems currently employed for breast cancer combine nuclear grade, tubule formation and mitotic rate. In general, each element is given a score of 1 to 3 (1 being the best and 3 the worst) and the score of all three components are added together to give the "grade" (1-4). The lowest possible score (1+1+1=3) is given to well differentiated tumors that all form tubules and have a low mitotic rate (<10/10 HPF). The highest possible score is 9 (3+3+3=9). The exact criteria for each component differ in each system and the systems are evolving as more detailed data becomes available (5-7). Some studies even suggest that mitotic rate alone can be as predictive as the grading systems(8).

Until recently, the most common grading systems used in the United States were the original Scarff-Bloom-Richardson (SBR) system as described above and the Black method which emphasizes nuclear grading and excludes consideration of tubules as a criteria (9). In Europe, the Elston-Ellis modification of the SBR grading system (Nottingham grading system) is preferred and is becoming increasingly popular in the US (7). This modification provides somewhat more objective criteria for the three component elements of grading and specifically addresses mitosis counting in a more rigorous fashion (4). For example hyperchromatic nuclei and apoptotic cells which are counted in the original SBR system are excluded in the Elston-Ellis modification and the area being assessed is specifically defined in square millimeters. These modifications have enhanced reproducibility of grading among pathologists and to a considerable extent have fostered acceptance of grading by clinicians (7,10-20). An excellent historical discussion of grading systems can be found in Elston and Ellis (17).

Criteria for grading are an active area of investigation particularly in regards to defining more objective criteria for assessing nuclear grade and we should expect image analysis to greatly contribute to this area in the future. The beginner is encouraged to consult their local pathologist to determine which system is used in their institution. The examples provided here, by Dr. Hanne Jensen, illustrate how the Nottingham Grading System can be used to grade a tumor.

NOTTINGHAM GRADING SYSTEM

Tubule formation

* Majority of Tumor (>75%) 1

* Moderate Degree (10-75%) 2

* Little or None (<10%) 3

Mitotic count

* 0-9 Mitoses/10 hpf 1

* 10-19 Mitoses/10 hpf 2

* 20 or > Mitoses/10 hpf 3

Nuclear Pleomorphism

* Small Regular Uniform Cells 1

* Moderate Nuclear Size and Variation 2

* Marked Nuclear Variation 3

COMBINED HISTOLOGIC GRADE

* Low Grade (I) 3-5

* Intermediate Grade (II) 6-7

* High Grade (III (8-9)

http://ccm.ucdavis.edu/bc...ng_diagram.html

Wyniki chyba powinny byc zapisane tak:

NHG II (3+2+1)
NHG rzeczywiscie II stopnia ale niejasne jest w jakiej kolejnosci zrobiony zostal zapis czastkowy bo

2 mitozy/10 HPF maja wartosc rowna 1. W standardowym zapisie ta wartosc jest w srodku, tutaj jest podana na koncu.
Mitoza to podzial komorek. Im nizsza wartosc tym wolniej komorki sie dziela czyli rak rozwija sie wolniej.
Tak czy owak wartosc prognostyczna wynosi II czyli lezy w srodku skali.

Niemniej jednak opis jest niepelny (albo moze nie przepisalas wszystkiego?) - brakuje np okreslenia typu raka oraz jego hormonozaleznosci tudziez statusu HER2.

Pozdrawiam serdecznie,

zosia