Comparison of histological grading methods in mucoepidermoid carcinoma of minor salivary glands.
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Date
2016-10
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Abstract
Context: Mucoepidermoid carcinoma (MEC) is the most common salivary
gland malignancy and its grading is greatly consequential in the management
and prognosis of patients with the disease. Aims: To compare histologic
grading systems in MEC of minor salivary glands. Settings and Design: Two
qualitative (modified Healy and Memorial Sloan‑Kettering Cancer Center [MSKCC]
methods) and two quantitative (Armed Forces Institute of Pathology [AFIP] and
Brandwein methods) were evaluated. Subjects and Methods: Diagnostics slides
of 19 patients including one recurrent case were evaluated using the four grading
systems. Statistical Analysis Used: Percentages and proportions were used.
Results: Agreement across all grading system was found to be very low (32%)
while there was a better agreement between AFIP and MSKCC methods (84%)
between modified Healy and Brandwein (58%). The method that gave the poorest
agreement with all the others was the Brandwein grading. In general, the AFIP
and MSKCC methods tended to grade the tumors lower while the Brandwein
and modified Healy methods seemed to grade them higher. Conclusions: Most
MEC of minor salivary glands appear to be low‑grade tumors. It is conceivable
that some grading methods (Brandwein and modified Healy) may lead to an
unnecessary escalation of management methods in these tumors. The MSKCC
method may have emphasized some parameters which may not have much
importance in minor salivary gland MEC. The AFIP method appears to be the
most appropriate to use for the grading of minor salivary gland MEC. Further
studies are required to confirm or disprove this finding.
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Keywords
Histological grading, minor salivary glands, mucoepidermoid carcinoma
Citation
Qannam Ahmed, Bello Ibrahim O. Comparison of histological grading methods in mucoepidermoid carcinoma of minor salivary glands. Indian Journal of Pathology & Microbiology. 2016 Oct-Dec 59(4): 457-462.