St. Anne-Mayo grading system of astrocytomas
Citation, DOI, disclosures and article data
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The St. Anne-Mayo grading system, also known as the Daumas-Duport grading system, introduced in 1988 was for a time a popular system for grading diffuse astrocytomas but has now been replaced by the WHO grading system which, however, was derived from the St Anne-Mayo system and thus shares many similarities 1-3.
The St. Anne-Mayo grading system is a 4 tiered system and uses the presence of 4 morphologic criteria to assign a grade:
- nuclear atypia
- endothelial proliferation - 'piled-up' endothelial cells. NOT hypervascularity
The grade then depends on the accumulation of these criteria as follows:
- grade 1: 0 criteria
- grade 2: 1 criterion (usually nuclear atypia)
- grade 3: 2 criteria (usually nuclear atypia and mitosis)
- grade 4: 3 or 4 criteria
Note that, unlike the WHO classifications up to and including the revised 4th edition (2016) that used Roman numerals, the St. Anne-Mayo system used Arabic numerals. This has been adopted by the 5th edition of the WHO classification (2021) 5.
History and etymology
Named after Catherine Daumas-Duport, a French pathologist 2 from Sainte Anne hospital who also worked together with the Mayo-Clinic in the United States 4.
- 1. Prayson RA, Cohen ML. Practical Differential Diagnosis in Surgical Neuropathology. Humana Press. (2000) ISBN:0896038173. Read it at Google Books - Find it at Amazon
- 2. Daumas-Duport C, Scheithauer B, O'Fallon J, Kelly P. Grading of Astrocytomas. A Simple and Reproducible Method. Cancer. 1988;62(10):2152-65. doi:10.1002/1097-0142(19881115)62:10<2152::aid-cncr2820621015>3.0.co;2-t [Pubmed]
- 3. Andrew H. Kaye, Essential Neurosurgery. John Wiley & Sons. (2009) ISBN:1405148179. Read it at Google Books - Find it at Amazon
- 4. Kelly PJ, Daumas-Duport C, Scheithauer BW et-al. Stereotactic histologic correlations of computed tomography- and magnetic resonance imaging-defined abnormalities in patients with glial neoplasms. Mayo Clin. Proc. 1987;62 (6): 450-9. Pubmed citation
- 5. Louis D, Perry A, Wesseling P et al. The 2021 WHO Classification of Tumors of the Central Nervous System: A Summary. Neuro Oncol. 2021;23(8):1231-51. doi:10.1093/neuonc/noab106