title: Pathological grading for predicting metastasis in phaeochromocytoma and paraganglioma.
abstract: Phaeochromocytomas (PHEO) and paragangliomas are rare catecholamine-producing tumours. Although 10-30% of these tumours metastasise, histopathological criteria to discriminate malignant from benign tumours have not been established; therefore, reliable histopathological markers predicting metastasis are urgently required. A total of 163 tumours, including 40 metastatic tumours, collected by the Phaeochromocytoma Study Group in Japan (PHEO-J) were analysed using a system called grading system for adrenal phaeochromocytoma and paraganglioma (GAPP). The tumours were scored based on GAPP criteria as follows: histological pattern, cellularity, comedo-type necrosis, capsular/vascular invasion, Ki67 labelling index and catecholamine type. All tumours were scored from 0 to 10 points and were graded as one of the three types: well-differentiated (WD, 0-2 points), moderately differentiated (MD, 3-6 points) and poorly differentiated (PD, 7-10 points). GAPP scores of the non-metastatic and metastatic groups were 2.08±0.17 and 5.33±0.43 (mean±s.e.m., P<0.001) respectively. There was a significant negative correlation between the GAPP score and the interval until metastasis (r=-0.438, P<0.01). The mean number of years until metastasis after the initial operation was 5.5±2.6 years. The study included 111 WD, 35 MD and 17 PD types. The five-year survival of these groups was 100, 66.8 and 22.4% respectively. In addition, negative immunoreactivity for succinate dehydrogenase gene subunit B (SDHB) was observed in 13 (8%) MD or PD tumours and ten of the 13 (77%) had metastases. Our data indicate that a combination of GAPP classification and SDHB immunohistochemistry might be useful for the prediction of metastasis in these tumours.
authors: Noriko
authors: N
authors: Kimura
authors: Ryoichi
authors: R
authors: Takayanagi
authors: Nae
authors: N
authors: Takizawa
authors: Eiji
authors: E
authors: Itagaki
authors: Takayuki
authors: T
authors: Katabami
authors: Narihiko
authors: N
authors: Kakoi
authors: Hiromi
authors: H
authors: Rakugi
authors: Yukihiro
authors: Y
authors: Ikeda
authors: Akiyo
authors: A
authors: Tanabe
authors: Takeshi
authors: T
authors: Nigawara
authors: Sadayoshi
authors: S
authors: Ito
authors: Itaru
authors: I
authors: Kimura
authors: Mitsuhide
authors: M
authors: Naruse
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D016022:Case-Control Studies; D002395:Catecholamines / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009362:Neoplasm Metastasis; D010235:Paraganglioma / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D010673:Pheochromocytoma / Q000378:metabolism / Q000401:mortality / Q000556:secondary*; D011379:Prognosis; D013385:Succinate Dehydrogenase / Q000378:metabolism*; D015996:Survival Rate; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D002395:Catecholamines; C108095:SDHB protein, human; D013385:Succinate Dehydrogenase
keywords: histopathological diagnosis; immunohistochemistry; metastasis; paraganglioma; phaeochromocytoma; succinate dehydrogenase gene subunit B; survival