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Grading der Tumoren des tubulären Verdauungssystems

Ösophagus, Magen, Kolon und Rektum

Grading of tumors in the tubular digestive tract

Esophagus, stomach, colon and rectum

  • Schwerpunkt: Grading-Systeme
  • Published:
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Zusammenfassung

Das Grading von Tumoren des tubulären Verdauungssystems ist integraler Bestandteil einer pathologischen Begutachtung, in seiner prognostischen Aussagekraft allerdings der Tumortypisierung nachgeordnet. Eine unabhängige prognostische Bedeutung des Gradings ist für die meisten Tumoren des Verdauungstrakts nicht erwiesen, dennoch spielt es gerade in den frühen UICC-Stadien (Union internationale contre le cancer) im klinischen Alltag eine Rolle, da es als Entscheidungshilfe für weitere therapeutische Strategien herangezogen wird. Eine wesentliche Neuerung hat sich im Routinealltag in der Pathologie für das Grading kolorektaler Karzinome ergeben. Diese werden auch bei konventionell-histologisch geringer Differenzierung wegen des Vorliegens einer Mikrosatelliteninstabilität aufgrund der grundsätzlich besseren Prognose dieser Tumoren als „low grade“ (G1/G2) eingestuft.

Abstract

Grading of tumors located in the tubular digestive tract is an integral component of pathology assessment reports but is subordinate to the histological typing of tumors with respect to the prognostic significance. Tumor grading has not been shown to be an independent prognostic marker for most tumor entities in the gastrointestinal tract; however, it may be relevant for further routine treatment decision making in early Union Internationale Contre le Cancer (UICC) stage cancers in which the prognosis for patients is less dominated by advanced tumor spread. Owing to the more favorable prognosis of microsatellite instability in colorectal cancer, the World Health Organization (WHO) has recommended that poorly differentiated tumors should be tested and graded as low grade (G1/G2) when microsatellite instability is detected. This recommendation has been integrated into the German S3 guidelines for colorectal cancers. Accordingly, microsatellite instability testing for grading purposes should become routine practice.

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Authors and Affiliations

  1. Institut für Pathologie, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland

    H. Bläker

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  1. H. Bläker
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Dieser Beitrag beinhaltet keine vom Autor durchgeführten Studien an Menschen oder Tieren.

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C. Wittekind, Leipzig

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Bläker, H. Grading der Tumoren des tubulären Verdauungssystems. Pathologe 37, 293–298 (2016). https://doi.org/10.1007/s00292-016-0165-9

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