New, comprehensive tumor classification combines molecular biology and classic pathology

Information about the genetic make-up of tumors should, in the long term, help clinicians decide on the most effective course of treatment for patients with cancer. To be most helpful these molecular data must be incorporated into a tumor classification that includes morphological and clinical information. Jules Berman describes his ideas for a new comprehensive tumor classification in BMC Cancer this week.

Berman, the Program Director for Pathology Informatics within the National Cancer Institute's Cancer Diagnosis Program, USA, writes: "This classification is simple (reducing the complexity of information received from the molecular analysis of tumors), comprehensive (providing a place for every tumor of man), and consistent with recent attempts to characterize tumors by cytogenetic and molecular features."

"Traditionally, tumors have been classified by their morphologic appearances," he continues. "Unfortunately, tumors with similar histologic features often follow different clinical courses or respond differently to chemotherapy." The alternative, a classification based solely on the molecular characteristics of tumors, would sacrifice the clinical/pathological experiences that inform virtually every clinical decision related to the diagnosis and treatment of patients with cancer.

Both the type of cells from which a tumor is derived and the molecular characteristics of those cells determine how a tumor will behave information of great importance to clinicians. Berman has organized his classification using these two features.

At the highest level of the classification, tumors are grouped according to the component cells' developmental history their 'histogenesis'. For example leukemia would be classified as a mesenchyme-derived tumor. Patterns identified from the gene expression and proteomic data from tumor samples can then be integrated as new groups within this classification.

Berman writes: "Some of these groupings w

Contact: Gemma Bradley
BioMed Central

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