Staging, grading, tumor hierarchy, and tumor progression

Lecture 01 - TNM staging, grading, tumor classification hierarchy, and tumor progression

TNM

tumor, nodes, metastasis

T = primary tumor

describes size/extent of the primary tumor

N = regional lymph nodes

indicates whether cancer has spread to regional lymph nodes

M = distant metastasis

indicates whether cancer has spread to distant locations

T0

no evidence of primary tumor

Tis

carcinoma in situ

T1

limited to pancreas, < 2cm

T2

limited to pancreas, > 2cm

T3

extends beyond pancreas

T4

involves major arteries and is unrespectable

N0

no regional-node metastasis

N1

regional-node metastasis

M0

no distant metastases

M1

distant metastases

Grading

describes how abnormal the cancer cells look and how differentiated they are

Grade 1

well differentiated; looks most like normal tissue —> low grade

Grade 2

moderately differentiated —> intermediate

Grade 3

poorly differentiated —> high grade

Grade 4

undifferentiated; most abnormal —> highest grade

Differentiation state

1. epithelial

2. nonepithelial

3. mixed

Embryonic orgin

1. ectoderm

2. endoderm

3. mesoderm

ectoderm

epidermis of skin, nervous system, sense organs

mesoderm

skeleton, muscles, blood vessels, heart, blood, gonads, kidneys, dermis of skin

endoderm

lining of digestive and respiratory tracts, liver, pancreas, thymus, thyroid

biological behavior

1. benign

2. malignant

Hyperplastic

increased cell number while tissue still looks relatively normal

Metaplastic

minimal but apparent change in tissue structure; one type of cell replaced by another cell type

Dysplastic

cell appearance and tissue composition changes; represents transition from benign to premalignant

Neoplasia

cells invade surrounding tissues; invasion is generally associated with malignant disease