Invited Commentary

Excerpt

The article titled “Hiological grading in garic cancer by Ming classification: Correlation with hiopathological subtypes, metaasis and prognosis,” by Thomas Luebke et al. reports correlation the Ming classification with other classification syems for garic cancer. The study was designed to clarify the degree of usefulness of the Ming syem for evaluation of tumor progression, lymph node metaasis, and prognosis. The authors demonstrated that the Ming classification correlated well with conventional grading and classification syems for garic cancer. Additionally, the Ming classification had prognoic relevance, with a worse prognosis for Ming infiltrative type than for expansive type (P = 0.0847). At the same time, the authors suggest that the Ming classification does not fulfill requirements for preoperative prediction of surgical curability and prognosis because biopsies are generally not representative of tissue at the invasive front. In addition, preoperative classification with the Ming syem may be even more misleading when biopsy sample size is small. In conclusion, Luebke et al., suggest that the Ming classification was easy to use, biologically, clinically, and prognoically relevant, and easily reproducible as long as classification was based on a resected specimen. The authors had two particular points of emphasis in their report: (1) There is specific prognoic relevance with the Ming classification between the expansive hiologic type and the infiltrative type. At present, there is a general understanding that invasive features described as “expansive” are prognoic factors for garic cancer. (2) The Ming classification is easily applied to postoperative analysis of a resected specimen, but it is important to note that detailed hiological inveigation of such specimens obtains more information than the Ming classification. …