Grading

Grading of carcinomas is mandatory for adequate treatment (e.g. prostate, breast, endometrium, liver, kidneys) and several systems are available. Simplest consists of counting mitotic figures in defined microscopic areas. For some cancers micro-staging procedures are routinely applied (melanoma, carcinomas of organs with a cavity such as urinary bladder, gut, endometrium, uterine cervix, vulva) and consist of depth of invasion, tumour thickness, and type of margins (pushing, infiltrating).

For final diagnosis pathological reports should employ standardized nomenclature and coding using dedicated, computer-assisted reporting systems. Where appropriate, checkpoints for technical quality assurance should be incorporated. Due to rapidly expanding immunological, cytogenetic, and molecular techniques careful planning of supplementary methods is required; a tissue bank of snap-frozen samples of tumours and the corresponding normal tissues of the same patient is recommended.

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