title: Correlation between nuclear grade and biological prognostic variables in invasive breast cancer.
abstract: BACKGROUND
  Grading of carcinomas is an estimation of differentiation. Nuclear grading is the cytological evaluation of tumor nuclei in comparison with the nuclei of normal mammary epithelial cells. Because nuclear grading does not involve an assessment of the growth pattern of the tumor, it applies not only to invasive ductal carcinoma but also to other subtypes of breast carcinoma.
  
  
  METHODS
  A total of 215 primary breast carcinomas obtained from the Affiliated Kihoku Hospital of Wakayama Medical College were enrolled in our present study. Nuclear grade was evaluated according to the criteria of the National Surgical Adjuvant Study of Breast Cancer (NSAS-B) protocol. Immunohistochemistry was also performed to determine Bcl-2, p53, c-erbB-2, estrogen receptor (ER) and MIB-1 expression in paraffin-embedded tissues for all cases.
  
  
  RESULTS
  Thirty-two (14.9%) of the patients were graded as 1,124 (57.7%) as 2, and 59 (27.4%) as 3. Nuclear grade displayed a negative correlation with Bcl-2 expression (r=-0.308, p<0.0001), and a positive correlation with c-erbB-2 overexpression (r= 0.172, p=0.0117) and tumor proliferative index labeling by MIB-1 (r=0.485, p<0.0001).
  
  
  CONCLUSIONS
  These results imply that nuclear grade is related to the characteristics of tumor biology, indicating that the morphology and biology of breast cancer are tightly linked. Our present results also suggest that adding the nuclear grade to the pathological diagnosis of invasive breast carcinoma may be clinically useful for predicting tumor behavior, for example aggressiveness, and for prognostication.
authors.affiliation: Second Department of Pathology, Wakayama Medical College, 811-1, Kimiidera, Wakayama City, Wakayama 641-0012, Japan.
authors.forename: Q
authors.initials: Q
authors.lastname: Yang
authors.forename: I
authors.initials: I
authors.lastname: Mori
authors.forename: T
authors.initials: T
authors.lastname: Sakurai
authors.forename: G
authors.initials: G
authors.lastname: Yoshimura
authors.forename: T
authors.initials: T
authors.lastname: Suzuma
authors.forename: Y
authors.initials: Y
authors.lastname: Nakamura
authors.forename: M
authors.initials: M
authors.lastname: Nakamura
authors.forename: E
authors.initials: E
authors.lastname: Taniguchi
authors.forename: T
authors.initials: T
authors.lastname: Tamaki
authors.forename: T
authors.initials: T
authors.lastname: Umemura
authors.forename: K
authors.initials: K
authors.lastname: Kakudo
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D001943:Breast Neoplasms / Q000737:chemistry / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000737:chemistry / Q000473:pathology; D018275:Carcinoma, Lobular / Q000737:chemistry / Q000473:pathology; D002467:Cell Nucleus / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis
chemical_list: D014408:Biomarkers, Tumor