title: Cytologic grade independently predicts survival of patients with pancreatic adenocarcinoma.
abstract: Our objectives were to devise a cytologic grading system and determine whether it would predict survival of patients with solid-type pancreatic adenocarcinoma. We evaluated 116 consecutive patients from July 2000 to November 2002; they were followed up until September 2003. We scored the following features on rapid Romanowsky-stained endoscopic ultrasound-guided fine-needle aspiration smears: cell group architecture, single cells, nuclear grade, mucus, bizarre cells, and necrosis. A cytologic grade (low vs high) was assigned. The Kaplan-Meier estimate of 6-month survival was 76% (SE, 7%) for patients with low-grade tumors vs 50% (SE, 6%) for patients with high-grade carcinoma. The median survival for patients with low-grade vs high-grade tumors was 1 year vs 6 months, respectively (chi2 = 4.45; P = .035). Cox proportional hazards regression showed tumor stage, cancer-specific treatment, and cytologic grade to be independent predictors of survival (P = .001). No other factors (age, mass location, placement of stent, presence of concomitant chronic pancreatitis, race, sex) predicted survival. We devised a grading system that independently predicted survival in patients with pancreatic adenocarcinoma.
authors.affiliation: Department of Pathology, Division of Anatomic Pathology, University of Alabama at Birmingham, AL, USA.
authors.forename: Isam A
authors.initials: IA
authors.lastname: Eltoum
authors.forename: Mohamad A
authors.initials: MA
authors.lastname: Eloubeidi
authors.forename: David C
authors.initials: DC
authors.lastname: Chhieng
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Tamhane
authors.forename: Ralph
authors.initials: R
authors.lastname: Crowe
authors.forename: Darshana
authors.initials: D
authors.lastname: Jhala
authors.forename: Kay D
authors.initials: KD
authors.lastname: St John
authors.forename: C Mel
authors.initials: CM
authors.lastname: Wilcox
authors.forename: Gene P
authors.initials: GP
authors.lastname: Siegal
authors.forename: Selwyn
authors.initials: S
authors.lastname: Vickers
authors.forename: Nirag C
authors.initials: NC
authors.lastname: Jhala
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001399:Azure Stains; D004801:Eosine Yellowish-(YS); D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology*; D016016:Proportional Hazards Models; D015203:Reproducibility of Results
chemical_list: D001399:Azure Stains; C046541:Romanowsky-Giemsa stain; D004801:Eosine Yellowish-(YS)