Grading And Staging Grading is based on the

Grading And Staging • Grading is based on the microscopic features of the cells which compose a tumor and is specific for the tumor type. • Staging is based on clinical, radiological, and surgical criteria, such as, tumor size, involvement of regional lymph nodes, and presence of metastases. Staging usually has prognostic value.

Staging and Grading Gradin– Ingthe diagram below utilizing an adenocarcinoma as an example, the principles of grading are illustrated:

Staging • Anatomical spread of tumor based on -size of tumor -spread to regional L. N -presence or absence of metastasis TNM staging system & AJC

Staging and Grading • In this diagram utilizing a lung carcinoma as an example, the principles of staging are illustrated:

Diagnostic Methods for Neoplasia • History and Physical Examination • learning from : • talking to the patient. direct examination clues to the presence of a neoplasm. Signs and symptoms such as weight loss, fatigue, and pain may be present. A mass may be palpable or visible.

Diagnostic Methods for Neoplasia • Radiographic Techniques The use of plain films (x-rays), computed tomography (CT), magnetic resonance imaging (MRI), mammography, and ultrasonography (US) may be very helpful to detect the presence and location of mass lesions. The findings from these methods may aid in staging and determination of therapy.

biochemical assays • tumor markers: sometimes diagnostic or prognostic • can be helpful in monitoring effectiveness of therapy or in detecting relapses/recurrences • Serum tumor markers: prostate specific antigen, CEA , β-HCG , α-FETOPROTEIN. . . etc )may help to determine the presence of specific neoplasms. not perfect screening tools in a general population.

Pathological Diagnostic Procedures • • FNA (fine needle aspiration) cytological smears biopsy frozen sections

Diagnostic Methods for Neoplasia • Cytology • • • sample cells simple cost-effective minimally invasive. e. g : Pap smear for the diagnosis of cervical dysplasias and neoplasms. • Cells exfoliated into body fluids can be examined. • Fine needle aspiration (FNA) can be used also.

Diagnostic Methods for Neoplasia • Tissue Biopsy and Surgery Methods that sample small pieces of tissue (biopsy) from a particular site, often via endoscopic techniques (such as colonoscopy, upper endoscopy, or bronchoscopy) can often yield a specific diagnosis of malignancy. At surgery, portions of an organ or tissue can be sampled, or the diseased tissue(s) removed and examined in surgical pathology to determine the stage and grade of the neoplasm.