NCLEX Review & Nursing School

Tumor Grading

– we examine the tumor through biopsy under a microscope.
– abnormality of the cells determines the grade of the cancer.
– increasing abnormality increases the grade, from 1–4.

Grade 1     Cells slightly abnormal and well differentiated
Grade 2     Cells more abnormal and moderately differentiated
Grade 3     Cells very abnormal and poorly differentiated
Grade 4     Cells immature and undifferentiated

Cancer Staging

Staging is the classification of the extent of the disease. There are several types of staging methods. The tumor, node, metastases (TNM) system classifies cancer by tumor size (T), the degree of regional spread or node involvement (N), and distant metastasis (M).

Tumor (T)

T0
No evidence of tumor
Tis     Carcinoma in situ (limited to surface cells)
T1-4     Increasing tumor size and involvement

Node (N)

N0     No lymph node involvement
N1-4     Increasing degrees of lymph node involvement
Nx     Lymph node involvement cannot be assessed

Metastases (M)

M0     No evidence of distant metastases
M1     Evidence of distant metastases

A numerical system also is used to classify the extent of disease.

Stage 0     Cancer in situ (limited to surface cells)
Stage I     Cancer limited to the tissue of origin, evidence of tumor growth
Stage II     Limited local spread of cancerous cells
Stage III     Extensive local and regional spread
Stage IV     Distant metastasis