The Significance of the “KGS Practice” in Pathology and Oncology Part 2

PART 2:  INTRODUCTION 

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INTRODUCTION

To long-term chemotherapy patients’ routine questions like “How is my condition, and how is my chemotherapy doing?”, doctors’ answers ought to be clearer and more reassuring than in-between ones like “We don’t really see the whole picture yet, so we’ll have to wait and see.”, or “We’re not sure, but you seem to be doing well and we just hope to get success in this treatment.”, or “Right now, we don’t really know what to tell you.”, or “We’ve got nothing to tell you at this point in time.”

The KGS, the “Karindas Grading System” unprecedentedly gives the physician the capability and ease to inform the patient of the prognostic contour more manifestly and satisfactorily. It provides the clinician with able guidance and tools for the perceptibility of diagnostics and the command of the visibility and judgement in the prognostic progression, and enables the researcher to have a better view, perspective and reckoning and wider qualified space of methodology.

In the limited-scale histological grading systems we use in oncology today, the grading is done by examining tumor cells in regard to their differentiation [34, 134]   and calculating their volume in bulk with the proportions of their differentiation/undifferentiation. Some add to that tumor necrosis [19,96,99,134]   and mitotic counts [88,90-94,96,97], and some further add nuclear size/pleomorphism [88,89,95,96,134]. Withal, solely determining the degree of the differentiation of the cells and reckoning them without the rest of the elements and determinants through the oncogenic progression leaves the grading limited and incomplete. This makes the grading weak and ineffective depriving the clinician and researcher of a dependable base of exposure to lean on in their work. Such a grading of low prognostic value is scientifically not full-length serviceable, and it is not practically sufficient to contribute to a standardized phenotypic cellular evaluation of a tumor tissue and its microenvironment while it is basically looked to as an important tool to provide the clinician with a clear path to successful clinical management.

This frailness of calibration and under-reckoning in the current grading systems is rather unfortunate as it affects the clinical management of cancer patients in terms of prognostic follow-up and investigative and therapeutic conduct whose consequential inefficacy ultimately contributes to unimpressive survival rates in clinical oncology.

Having its parameters based on cell–specific features and cell-dedicated conditions, the informative and instructive KGS provides a universal across-the-board paradigm for examining, observing and evaluating the phenotypic and genotypic identities of cells and also for grading their tissues within a wide spectrum of possibilities of conditions and situations ranging from normality to anaplasia.

The KGS functions as a single all-around reference system of grading. It gathers  tumors’ clinical and molecular characteristics on a combined integral platform of cellular and tissue identification and profiling with its wide and overall parametric range. It gives an ID to each cell (cell type) by histologic typing; it classifies the cell morphology, how normal or abnormal a tissue’s cells look, what identity changes they may show, how they present their changes, how they arrange themselves in relation to each other, how they behave or misbehave, and how fast they grow when misbehaving, and how quickly they disseminate. Also taking account of additional information related to the changes and happenings around the cells within the microenvironment, it provides the examiner with full guiding data.

Keeping the KGS’s parametric range wide and overall proves essential and necessary since it aims at providing complete guidance with comprehensive pathobiologic data of tissue processes, development, and consequences between inertness, normality and the outermost levels of pathology, the “oncogenesis” itself, the most infamous abnormal tissue event in the human body, a highly-organized cellular disorder [20] which we can not afford to deal with without including all of its players for consideration.