title: Cytometry and morphometry of malignant fibrous histiocytoma of the extremities. Prediction of metastasis and mortality.
abstract: Flow cytometry and nuclear morphometry were compared with traditional pathologic grading techniques for predicting the course of malignant fibrous histiocytoma of the extremities. Clinical, pathologic, and flow/morphometric variables from 53 cases were tested by Cox regression for prediction of distant recurrence and mortality. Tumor grading based on extent of tumor necrosis was a significant predictor for both disease-free survival (p = .014) and overall survival (p = .003). The fraction of nuclei in the S + G2M segment of DNA histograms was significant for disease-free survival (p = .007), and remained significant (p = .033) in a joint Cox model with necrosis-based grade (p = .004 for the bivariate model). Relative risk for recurrence varied nearly 10x between the 10th and 90th percentiles of grade and (S + G2M)1/2. Overall survival was predicted by a nuclear shape feature termed "R" (p = .000008), the casewise difference (residual) between expected and observed nuclear perimeter as a function of average Feret diameter. In a bivariate Cox model, relative risk of mortality varied 35x between the 10th and 90th percentiles of grade and R. Cytometric and morphometric data contain information about recurrence-free and overall survival beyond that available from more usual clinical and pathologic features. It seems likely that nuclear morphometry, in particular, will prove to be a useful aid for estimating the prognosis of patients with malignant fibrous histiocytoma of the extremities.
authors.affiliation: Department of Cellular Pathology, Armed Forces Institute of Pathology, Washington, D.C. 20306-6000.
authors.forename: R L
authors.initials: RL
authors.lastname: Becker
authors.forename: D
authors.initials: D
authors.lastname: Venzon
authors.forename: E E
authors.initials: EE
authors.lastname: Lack
authors.forename: U V
authors.initials: UV
authors.lastname: Mikel
authors.forename: S W
authors.initials: SW
authors.lastname: Weiss
authors.forename: T J
authors.initials: TJ
authors.lastname: O'Leary
mesh_terms: D004273:DNA, Neoplasm / Q000032:analysis; D005121:Extremities; D005260:Female; D005434:Flow Cytometry; D018219:Histiocytoma, Benign Fibrous / Q000737:chemistry / Q000453:epidemiology / Q000401:mortality / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000473:pathology; D011237:Predictive Value of Tests; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D013053:Spectrophotometry
chemical_list: D004273:DNA, Neoplasm