Reconciliation between the clinical and pathological staging of cancer

Abstract

This study aims for the reconciliation between models of clinical and pathology-based staging to obtain a more accurate assessment of the main factors of prognostic determinants in the classification for cancer staging. Clinical staging was performed on adenocarcinoma of the colon from five patients with age ranging from 57 to 76 years. Clinical stage was based on determining malignant size, estimating doubling time and deriving hypoxic cell energy using the Emad formula. A pathology-based staging was also performed on the same tumours to determine in vitro estimation of cell proliferation of tumour slices by tritiated thymidine incorporation, hypothesising that the malignant fraction of the detected tumour is the fraction of the tumour unlabelled by the tritiated thymidine. The consistency of results of the factors from the two staging types and their histologic grades were analysed using ANOVA. Perfect correlations between cancer staging factors using the clinical mathematical model and pathology based was confirmed (R 2 = 0.98). This provides a clear-cut criterion for accepting the hypotheses of both models for staging of cancer. It also strengthens the confidence in the equivalence of the energy of the unlabelled fraction of the tumour cells by the tritiated thymidine to that of the malignant fraction of the detected tumour (p < 0.0001). Besides the anatomical extent to which the disease has spread, both the tumour doubling time and the histologic classification are significant prognostic determinants which identify the specific tumour histologic grade which allows physicians to develop customised treatment plans for patients.

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References

  1. Barbalace K. Periodic table of elements—H—hydrogen. EnvironmentalChemistry.com. 1995–2011. Accessed on-line: 12/21/2011 http://EnvironmentalChemistry.com/yogi/periodic/H-pg2.html

  2. Birnie GD, Humexnunoun C (1962) Biochemical ex peninients towards the prediction of clinical responses to fluorinated pyrimidines. Proc Am Assoc Cancer Be search 3:304

    Google Scholar 

  3. Brown JM (1999) The hypoxic cell: a target for selective cancer therapy—eighteenth Bruce F. Cain Memorial Award lecture. Cancer Res 59:5863–5870

    CAS  PubMed  Google Scholar 

  4. Castello PR, David PS (2006) Mitochondrial cytochrome oxidase produces nitric oxide under hypoxic conditions: implications for oxygen sensing and hypoxic signaling in eukaryotes. Cell Metab 3:277–287

    CAS  PubMed  Article  Google Scholar 

  5. Fleming ID (1998) AJCC cancer staging handbook: for the AJCC Cancer Staging Manual. Lippincott Williams & Wilkins, USA

    Google Scholar 

  6. Gillies RJ, Gatenby RA (2007) Hypoxia and adaptive landscapes in the evolution of carcinogenesis. Cancer Metastasis Rev 26:1573

    Article  Google Scholar 

  7. Johnson HA, Bond VP (1961) A Method of labeling tissues with tritiated thymidine in vitro and its use in comparing rates of cell proliferation in duct epithelium, fibroadenoma, and carcinoma of human breast. Cancer 14:639–643

    CAS  PubMed  Article  Google Scholar 

  8. Lieb LM, Lisco H (1966) In vitro uptake of tritiated thymidine by carcinoma of the human colon. Cancer Res 26:733–740

    CAS  PubMed  Google Scholar 

  9. Lucas E (2006-01-31). FIGO staging of cervical carcinomas. screening.iarc.fr. http://screening.iarc.fr/viaviliappendix1.php. Retrieved 2010-10-14

  10. Matthay KK, Panina C (2001) Correlation of tumour and whole-body dosimetry with tumour response and toxicity in refractory neuroblastoma treated with 131I-MIBG. J Nucl Med 42:1713–1721

    Google Scholar 

  11. Minchinton A, Tannock I (2006) Drug penetration in solid tumours. Nat Rev Cancer 6:583–592

    CAS  PubMed  Article  Google Scholar 

  12. Moawad E (2010) Isolated system towards a successful radiotherapy treatment. Nucl Med Mol Imaging 44:123–136

    Article  Google Scholar 

  13. Moawad EY (2011) Radiotherapy and risks of tumour regrowth or inducing second cancer. Cancer Nanotechnol 2:81–93

    CAS  Article  Google Scholar 

  14. Moawad EY (2012) Clinical and Pathological Cancer Staging at the Nanoscale. Cancer Nanotechnology. doi:10.1007/s12645-012-0028-x

  15. Sullivan R, Graham CH (2007) Hypoxia-driven selection of the metastatic phenotype. Cancer Metastasis Rev 26:319–331

    CAS  PubMed  Article  Google Scholar 

  16. Wilson JMG, Jungner G (1968) Principles and practice of screening for disease. Geneva: World Health Organization. Public Health Papers, #34, Geneva, Switzerland

    Google Scholar 

  17. Wolberg WH, Brown RR (1962) Autoradiographic studies of in vitro incorporation of uridine and thymidine by human tumour tissue. Cancer Res 22:1113–1119

    CAS  PubMed  Google Scholar 

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The author declares that there is no conflict of interest concerning this paper.

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Correspondence to Emad Y. Moawad.

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The author is a member of the Korean Society of Nuclear Medicine and of the World Conference of Interventional Oncology (WCIO) USA.

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Moawad, E.Y. Reconciliation between the clinical and pathological staging of cancer. Comp Clin Pathol 23, 255–262 (2014). https://doi.org/10.1007/s00580-012-1603-6

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Keywords

  • Cancer staging
  • Histologic classification
  • Histologic grade
  • Emad formula