Grading gallbladder cancer

The grade is a description of how the cancer cells look compared to normal cells. To find out the grade of gallbladder cancer, the pathologist looks at a tissue sample from the tumour under a microscope. The pathologist gives gallbladder cancer a grade from 1 to 3. A lower number means the cancer is a lower grade.

How different the cancer cells are is described as differentiation.

Low grade means that the cancer cells are well differentiated. They look almost like normal cells. Lower grade cancer cells tend to be slow growing and are less likely to spread.

Intermediate grade means that the cancer cells are moderately differentiated. Their appearance and rate of growth is in between low-grade and high-grade cancer cells.

High grade means that the cancer cells are poorly differentiated or undifferentiated. They look less normal, or more abnormal. Higher grade cancer cells tend to grow more quickly and are more likely to spread than low-grade cancer cells.

Knowing the grade gives your healthcare team an idea of how quickly the cancer may be growing and how likely it is to spread. This helps them plan your treatment. The grade can also help the healthcare team predict future outcomes (your prognosis) and how the cancer might respond to treatment.

Expert review and references

  • Nakeeh, A., and Pitt, H. A. . Cancers of the Biliary Tree: Anatomy and Staging. Kelsen, D. P., Daly, J. M., Kern, S. E., Levin, B., Tepper, J. E., & Van Cutsem, E. (eds.). Principles and Practice of Gastrointestinal Oncology. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2008: 36:483-492.
  • Patel,T. and Borad, M.J. . Cancer of the biliary tree. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 53:715-733.