{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T03:17:59Z","timestamp":1792120679532,"version":"4.4.0"},"reference-count":23,"publisher":"Bioscientifica","issue":"3","content-domain":{"domain":["erc.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2014,6]]},"abstract":"<jats:p>\n                    Phaeochromocytomas (PHEO) and paragangliomas are rare catecholamine-producing tumours. Although 10\u201330% of these tumours metastasise, histopathological criteria to discriminate malignant from benign tumours have not been established; therefore, reliable histopathological markers predicting metastasis are urgently required. A total of 163 tumours, including 40 metastatic tumours, collected by the Phaeochromocytoma Study Group in Japan (PHEO-J) were analysed using a system called grading system for adrenal phaeochromocytoma and paraganglioma (GAPP). The tumours were scored based on GAPP criteria as follows: histological pattern, cellularity, comedo-type necrosis, capsular\/vascular invasion, Ki67 labelling index and catecholamine type. All tumours were scored from 0 to 10 points and were graded as one of the three types: well-differentiated (WD, 0\u20132 points), moderately differentiated (MD, 3\u20136 points) and poorly differentiated (PD, 7\u201310 points). GAPP scores of the non-metastatic and metastatic groups were 2.08\u00b10.17 and 5.33\u00b10.43 (mean\u00b1\n                    <jats:sc>s.e.m<\/jats:sc>\n                    .,\n                    <jats:italic>P<\/jats:italic>\n                    &lt;0.001) respectively. There was a significant negative correlation between the GAPP score and the interval until metastasis (\n                    <jats:italic>r<\/jats:italic>\n                    =\u22120.438,\n                    <jats:italic>P<\/jats:italic>\n                    &lt;0.01). The mean number of years until metastasis after the initial operation was 5.5\u00b12.6 years. The study included 111 WD, 35 MD and 17 PD types. The five-year survival of these groups was 100, 66.8 and 22.4% respectively. In addition, negative immunoreactivity for succinate dehydrogenase gene subunit B (SDHB) was observed in 13 (8%) MD or PD tumours and ten of the 13 (77%) had metastases. Our data indicate that a combination of GAPP classification and SDHB immunohistochemistry might be useful for the prediction of metastasis in these tumours.\n                  <\/jats:p>","DOI":"10.1530\/erc-13-0494","type":"journal-article","created":{"date-parts":[[2014,2,13]],"date-time":"2014-02-13T01:42:11Z","timestamp":1392255731000},"page":"405-414","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":360,"title":["Pathological grading for predicting metastasis in phaeochromocytoma and paraganglioma"],"prefix":"10.1530","volume":"21","author":[{"given":"Noriko","family":"Kimura","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryoichi","family":"Takayanagi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nae","family":"Takizawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiji","family":"Itagaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Katabami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narihiko","family":"Kakoi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromi","family":"Rakugi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukihiro","family":"Ikeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiyo","family":"Tanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Nigawara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadayoshi","family":"Ito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itaru","family":"Kimura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuhide","family":"Naruse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"_","family":"_","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"issue":"9","key":"1_18411311","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1038\/modpathol.3800160","volume":"17","author":"August","year":"2004","journal-title":"Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc","ISSN":"https:\/\/id.crossref.org\/issn\/0893-3952","issn-type":"print"},{"issue":"8","key":"2_34883995","doi-asserted-by":"publisher","first-page":"2817","DOI":"10.1210\/jc.2008-2504","volume":"94","year":"2009","journal-title":"Journal of Clinical Endocrinology &amp; 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