title: Nuclear atypia grading score is a useful prognostic factor in papillary gastric adenocarcinoma.
abstract: OBJECTIVE
  To investigate nuclear atypical in papillary gastric adenocarcinoma (PGA).
  
  
  RESULTS
  Hundred cases of PGA were classified into two groups according to nuclear pleomorphism and nuclear polarity; these groups were designated as high nuclear grade and low nuclear grade. Correlations between nuclear grade and clinicopathological features were evaluated for prognostic value. In order to evaluate which types of biological factors influence nuclear atypia, the expression of gastric-type mucin phenotype, p53, HER2 and Ki-67 detected by immunohistochemistry and DNA ploidy detected by laser scanning cytometry. The high nuclear grade group correlated with deeper wall invasion, the presence of lymphatic and venous invasion and the positivity of lymph node metastasis. High nuclear grade was an independent prognostic factor for disease-free survival. Moreover, significant correlations were observed between high nuclear grade and positivity of gastric-type mucin phenotype, p53 and HER2 and DNA aneuploidy.
  
  
  CONCLUSIONS
  Nuclear grade could be a new and useful morphological predictor for high malignant potential in PGA.
authors.affiliation: Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Nakashima
authors.forename: Takashi
authors.initials: T
authors.lastname: Yao
authors.forename: Minako
authors.initials: M
authors.lastname: Hirahashi
authors.forename: Shinichi
authors.initials: S
authors.lastname: Aishima
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kakeji
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
authors.forename: Masazumi
authors.initials: M
authors.lastname: Tsuneyoshi
mesh_terms: D000231:Adenocarcinoma, Papillary / Q000235:genetics / Q000401:mortality / Q000473:pathology*; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis / Q000235:genetics; D002467:Cell Nucleus / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D047569:Laser Scanning Cytometry; D008297:Male; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011003:Ploidies; D011379:Prognosis; D016016:Proportional Hazards Models; D013274:Stomach Neoplasms / Q000235:genetics / Q000401:mortality / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor