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Well-differentiated adenocarcinomas tend to resemble the glandular tissue that they are derived from, while poorly differentiated adenocarcinomas may not. By staining the cells from a biopsy , a pathologist can determine whether the tumor is an adenocarcinoma or some other type of cancer.
Depending on glandular architecture, cellular pleomorphism, and mucosecretion of the predominant pattern, adenocarcinoma may present three degrees of differentiation: well, moderately, and poorly differentiated. [5] Micrographs
If cells are not well differentiated, they will appear immature, will divide more rapidly, and will tend to spread. Well differentiated is given a grade of 1, moderate is grade 2, while poor or undifferentiated is given a higher grade of 3 or 4 (depending upon the scale used). The Nottingham system [12] is recommended for breast cancer grading ...
Hematoxylin and eosin stains from different sections of a single diffuse intrinsic pontine glioma specimen, showing low-grade (top) and high-grade (bottom) areas.. In pathology, grading is a measure of the cell appearance in tumors and other neoplasms.
[5] [6] Survival is significantly better in patients whose tumors are well differentiated (i.e. the glands and/or tubules are more completely developed) than when poorly differentiated (i.e. with rudimentary glands). [7] Some studies suggest that the oncogenes H-ras and fes are important drivers of oncogenesis in many acinar-type lung cancers. [8]
Gleason scores are often grouped together, based on similar behaviour: Grade 2-4 as well-differentiated, Grade 5-6 as intermediately-differentiated, Grade 7 as moderately to poorly differentiated (either 3+4=7, where the majority is pattern 3, or 4+3=7 in which pattern 4 dominates and indicates less differentiation., [6] and Grade 8-10 as "high ...
G (1–4): the grade of the cancer cells (i.e. they are "low grade" if they appear similar to normal cells, and "high grade" if they appear poorly differentiated) S (0–3): elevation of serum tumor markers; R (0–2): the completeness of the operation (resection-boundaries free of cancer cells or not) Pn (0–1): invasion into adjunct nerves
Less than 1% of patients with adenocarcinoma of the lung will exhibit this finding, but when it does occur, it is a poor prognostic factor. The exact mechanism of HPO is unknown but it is thought to be hormonal or neurogenic in etiology. The triad of HPO includes distal clubbing, arthritis, and bilateral symmetrical periosteal formation. [4]