{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:59:39Z","timestamp":1790791179813,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T00:00:00Z","timestamp":1612224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"publisher","award":["18H02633"],"award-info":[{"award-number":["18H02633"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"publisher","award":["17K08746"],"award-info":[{"award-number":["17K08746"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Science"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Three pathological grading systems advocated by Perzin\/Szanto, Spiro, and van Weert are currently used for adenoid cystic carcinoma (AdCC). In these systems, the amount or presence of the solid tumor component in AdCC specimens is an important index. However, the \u201csolid tumor component\u201d has not been well defined. Salivary AdCC cases (N\u00a0=\u00a0195) were collected after a central pathology review. We introduced a novel criterion for solid tumor component, minAmax (<jats:styled-content>min<\/jats:styled-content>or <jats:styled-content>a<\/jats:styled-content>xis <jats:styled-content>max<\/jats:styled-content>imum). The largest solid tumor nest in each AdCC case was histologically screened, the maximum oval fitting the solid nest was estimated, and the length of the minor axis of the oval (minAmax) was measured. The prognostic cutoff for the minAmax was determined using training and validation cohorts. All cases were evaluated for the four grading systems, and their prognostic impact and interobserver variability were examined. The cutoff value for the minAmax was set at 0.20\u00a0mm. Multivariate prognostic analyses showed the minAmax and van Weert systems to be independent prognostic tools for overall, disease\u2010free, and distant metastasis\u2010free survival while the Perzin\/Szanto and Spiro systems were selected for overall survival but not for disease\u2010free or distant metastasis\u2010free survival. The highest hazard ratio for overall survival (11.9) was obtained with the minAmax system. The reproducibility of the minAmax system (kappa coefficient of 0.81) was scored as very good while those of the other three systems were scored as moderate. In conclusion, the minAmax is a simple, objective, and highly reproducible grading system useful for prognostic stratification for salivary AdCC.<\/jats:p>","DOI":"10.1111\/cas.14790","type":"journal-article","created":{"date-parts":[[2020,12,30]],"date-time":"2020-12-30T09:00:23Z","timestamp":1609318823000},"page":"1184-1195","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Pathological evaluation of tumor grade for salivary adenoid cystic carcinoma: A proposal of an objective grading system"],"prefix":"10.1111","volume":"112","author":[{"given":"Naruhiko","family":"Morita","sequence":"first","affiliation":[{"name":"Department of Pathology and Molecular Diagnostics Graduate School of Medical Sciences Nagoya City University Nagoya Japan"},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Kobe University Graduate School of Medicine Kobe 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