TY - JOUR
T1 - Pathological evaluation of tumor grade for salivary adenoid cystic carcinoma
T2 - A proposal of an objective grading system
AU - Morita, Naruhiko
AU - Murase, Takayuki
AU - Ueda, Kaori
AU - Nagao, Toshitaka
AU - Kusafuka, Kimihide
AU - Nakaguro, Masato
AU - Urano, Makoto
AU - Taguchi, Ken ichi
AU - Yamamoto, Hidetaka
AU - Kano, Satoshi
AU - Tada, Yuichiro
AU - Tsukahara, Kiyoaki
AU - Okami, Kenji
AU - Onitsuka, Tetsuro
AU - Fujimoto, Yasushi
AU - Kawakita, Daisuke
AU - Sakurai, Kazuo
AU - Nagao, Toru
AU - Hanai, Nobuhiro
AU - Kawata, Ryo
AU - Hato, Naohito
AU - Otsuki, Naoki
AU - Nibu, Ken ichi
AU - Inagaki, Hiroshi
N1 - Funding Information:
Naruhiko Morita and Takayuki Murase contributed equally to this work. This work was supported in part by grants‐in‐aid for scientific research, MEXT, Japan (No. 18H02633 to H. Inagaki and 17K08746 to T. Murase). The authors thank Drs. Ayako Masaki, Kana Tsuda, Yuma Sakamoto, and Yoshihide Okumura (Nagoya City University, Japan) and Prof. Hiroshi Iwai (Kansai Medical University, Japan) for their valuable comments.
Funding Information:
This work was supported in part by grants-in-aid for scientific research, MEXT, Japan (No. 18H02633 to H. Inagaki and 17K08746 to T. Murase). Naruhiko Morita and Takayuki Murase contributed equally to this work. This work was supported in part by grants-in-aid for scientific research, MEXT, Japan (No. 18H02633 to H. Inagaki and 17K08746 to T. Murase). The authors thank Drs. Ayako Masaki, Kana Tsuda, Yuma Sakamoto, and Yoshihide Okumura (Nagoya City University, Japan) and Prof. Hiroshi Iwai (Kansai Medical University, Japan) for their valuable comments.
Publisher Copyright:
© 2020 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.
PY - 2021/3
Y1 - 2021/3
N2 - 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.
AB - 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.
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U2 - 10.1111/cas.14790
DO - 10.1111/cas.14790
M3 - Article
C2 - 33377247
AN - SCOPUS:85100096401
SN - 1347-9032
VL - 112
SP - 1184
EP - 1195
JO - Cancer Science
JF - Cancer Science
IS - 3
ER -
