Kristensen et al developed a grading score for the histologic features of the invading front from a squamous cell carcinoma of the cervix. The grading scheme resembles those used with squamous cell carcinoma of the head and neck. It can help identify patients with aggressive tumors requiring more aggressive management. The authors are from the Norwegian Radium Hospital in Oslo.
Site graded: The most invasive part of the tumor.
Parameters:
(1) degree of keratinization
(2) nuclear polymorphism (pleomorphism)
(3) pattern of invasion
(4) lymphoid infiltration and host response
|
Parameter |
Finding |
Points |
|
keratinization |
high (> 50% of cells) |
1 |
|
|
moderate (20-50% of cells) |
2 |
|
|
minimal (5 - 20% of cells) |
3 |
|
|
none (< 5% of cells) |
4 |
|
nuclear pleomorphism |
minimal (> 75% mature cells) |
1 |
|
|
moderate (50 - 75% mature cells) |
2 |
|
|
marked (25 - 50% mature cells) |
3 |
|
|
extreme (< 25% mature cells) |
4 |
|
pattern of invasion |
pushing, well-delineated border |
1 |
|
|
infiltrating cords, bands and/or strands |
2 |
|
|
in small cords or groups of infiltrating cells |
3 |
|
|
widespread cellular dissociation with single cells and/or small groups |
4 |
|
lymphoid infiltration |
marked |
1 |
|
|
moderate |
2 |
|
|
minimal/slight |
3 |
|
|
none |
4 |
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 4
• maximum score: 16
• A tumor with a score 4-8 had an excellent 5 year survival (97%).
• A tumor with a score 9-11 had a 5 year survival rate
|
Total Score |
5 Year Relapse Free Survival |
|
4 - 8 |
97% |
|
9 - 11 |
80% |
|
12 - 16 |
66% |
Specialty: Hematology Oncology, Surgery, general, Obstetrics & Gynecology
ICD-10: ,
