Publication: Selective nuclear morphometry as a prognostic factor of survival in renal cell carcinoma
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Date
1999
Authors
Monge, J.M. ; Val-Bernal, José Fernando ; Buelta, L. ; Garcia-Castrillo Riesgo, L. ; Asensio, L.
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Publisher
Murcia : F. Hernández
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DOI
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info:eu-repo/semantics/article
Description
Abstract
In the present study, we sought to determine
the predictive value of selective nuclear morphometry
(SNM) for patient outcome in renal cell carcinoma
(RCC). Tumor samples of 140 renal adenocarcinomas
diagnosed and treated with radical nephrectomy and
hilar lymphadenectomy between 1970 and 1988 with a
minimum follow up of 5 years in all the cases were
studied by SNM. The morphometric analysis was
performed in the most malignant tumor selected zone.
Selection was based on cytological criteria including
nuclear grade. Nuclear morphometric features analyzed
were: area, perimeter, major diameter, major and minor
diameter of the equivalent ellipse, volume of the
equivalent ellipse and sphere, circumference diameter,
and shape factors. The results showed that in the selected
zone tumor nuclei were larger than in the zones selected
at random. There was an inverse correlation between
morphometric parameters and survival and a direct one
between tumoral grade and stage. Tumors of the longterm
survival group of patients presented nuclei with
smaller morphometric measurements than tumors of
short term survival group, with significant differences
between them (pe0.05). In the survival analysis carried
out by the Kaplan-Meier method significant differences
existed between different groups formed from break
point for: area, perimeter, major diameter, major and minor diameter of the ellipse, volume of the ellipse and
sphere, circumference diameter and perimeter shape
factor. In the multivariate analysis carried out by the Cox
method, the feature with the most predictable value
related to survival, was the tumor stage. Morphometric
value with the highest punctuation in the test was major
nuclear diameter. The rest of the morphometric values
(except elliptic shape factor and elongation factor) were
also significant but they did not improve prognostic
information of the major nuclear diameter. SNM offers a
useful aid in a more objective grading of RCC. Multivariate
Cox analysis revealed additional value of
karyometry to tumor stage. SNM can be a useful tool for stratification of patients with RCC.
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