Score of Barletta et al for Grading a Lung Adenocarcinoma

 

Patient selection: lung adenocarcinoma

 

Parameters:

(1) growth pattern

(2) nuclear atypia

Parameter	Finding	Points
growth pattern	glandular areas (solid < 90%)	1
	solid growth >= 90%	2
nuclear atypia	mild to moderate	1
	high	2

 

where:

• Elements resemble the Bloom Richardson score for breast cancer. A third parameter for mitotic count per 10 high power fields had a high p value in the multivariate analysis.

• Scoring of 0 or 1 (vs 1 or 2) would be an alternative method.

 

total score =

= SUM(points for the 2 parameters)

 

Interpretation:

• minimum score: 2

• maximum score: 4

• The higher the score the higher the grade.

 

Total Score	Grade	Overall Survival at 4 Years
2	well-differentiated	70%
3	moderately differentiated	47%
4	poorly differentiated	15%

 

where:

• Overall survival for the poorly differentiated group was 0% at 78 months.

• Survival of well differentiated and moderately differentiated merged at 35% at 10 years (120 months)