page_title: Grading of the tumors of the central nervous system
section_title: St Anne-Mayo grading
hierarchical_section_title: Grading of the tumors of the central nervous system / St Anne-Mayo grading
caption_attribution_description: MRI of brain. (A) Initial MRI on February 16, 2005, shows a tumor in the right and left frontal lobe as well as the right thalamus. (B) MRI after surgery, radiation and chemotherapy. The tumor has completely disappeared except for slight enhancement adjacent to the surgical margin. (C) Recurrence of the thalamic tumor despite maintenance chemotherapy on November 16, 2005. (D) Increase in size of the thalamic tumor two months after stereotactic radiotherapy. (E) After 6 cycles of TMZ therapy, the thalamic lesion enlarged, and the patient developed dysarthria and hemiparesis. (F) After 2 courses of treatment with interferon-beta and TMZ, the tumor shows a partial response.
context_page_description: The concept of grading of the tumors of the central nervous system, agreeing for such the regulation of the "progressiveness" of these neoplasias, dates back to 1926 and was introduced by P. Bailey and H. Cushing,
  in the elaboration of what turned out the first systematic classification of gliomas.
  In the following, the grading systems present in the current literature are introduced. Then, through a table, the more relevant are compared.
context_section_description: The St Anne-Mayo grading system 
  also is used to grade astrocytomas; however, this system uses four morphologic criteria to assign a grade:
  a) nuclear atypia,
   
  b) mitosis,
   
  c) endothelial proliferation-'piled-up' endothelial cells. NOT hypervascularity
  d) necrosis.
  
  The St. Anne-Mayo grade has four categories of tumors:
  Grade 1 tumors do not meet any of the criteria.
  Grade 2 tumors meet one criterion, usually nuclear atypia.
  Grade 3 tumors meet two criteria, usually nuclear atypia and mitosis.
  Grade 4 tumors meet three or four of the criteria.
caption: MRI of a patient with anaplastic  astrocytoma.
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