Dysplasia in view of the cell cycle

Dysplasia is linked to altered tissue architecture. The lesion belongs into the diagnostic field of human pathology and is highly relevant for the clinical physician, because it breaks the criteria of hyperplasia and regeneration. Dysplasia is a precancerous disorder leading in all probability to malignant transformation if not treated. However, different descriptions do apply for dysplasia in different human tissues, and conventional pathology cannot arrive at unequivocal stringency. In contrast to the previous situation, now, dysplasia is defined by a unifying concept, which works upon cell cycle criteria. The decisive element for the proposed definition is unbalanced segregation of chromosomes and persistent genomic asymmetry through telophase, leading to aneuploid interphase nuclei. Progress of dysplasia can be estimated from the frequency of pathologic mitoses that directly measure cellular proliferation. In routine work, progress of dysplasia shall be quantified by frequency increase of aneuploidy in the increasing fraction of proliferating interphase nuclei. Thus, dysplasia is defined not only by aberrations from healthy histological architecture and normal cytological differentiation, but also by violations of the DNA standard from mitotic nuclei. The proposed classification of dysplasia measures the frequency of pathologic mitoses and the degree of genomic alterations in interphase nuclei. Both these criteria discriminate between low-grade and high-grade dysplasia and ascertain the malignant potential of a dysplastic lesion.