Architectural, morphometric and photometric features and their relationship to the main subjective diagnostic clues in the grading of prostatic cancer.
Novel software was developed to perform quantitative measurements of architectural and nuclear features in tissue sections. A pilot study was then undertaken to determine the diagnostic relevance of these quantitative features in prostatic tissue and the relationship of these objective features to the subjective clues used by practicing pathologists in the grading of prostatic adenocarcinoma. From a group of 82 cases of adenocarcinoma of the prostate with long-term follow-up, a subset of 15 cases that included 5 each in Mostofi grades I, II and III was carefully selected for analysis. Consecutive sections from each case were stained with hematoxylin and eosin or the Feulgen stain for visual and cytometric evaluations, respectively. The most important differences in the objective architectural features observed between the Mostofi grade I and II cases were the number of nuclei per gland and their distance from the glandular center. Significant differences were also noted in gland size and the variation in gland size. The Mostofi grades were also significantly different in terms of quantitative high-resolution features measuring nuclear size and its variation, total nuclear DNA content and the proportion of very aneuploid nuclei. There was a fairly good agreement between many of the subjective diagnostic clues and their corresponding quantitative architectural and nuclear features. This work (1) significantly extended the capabilities of our PC-based microphotometer system to analyze glandular tissue specimens, (2) provided insight into the objective bases for the expert diagnosis of adenocarcinomas of the prostate and (3) gave preliminary evidence of the ability of quantitative architectural features and high-resolution cytometric features to discriminate between the major diagnostic categories of these lesions.
Department of Pathology, University of Chicago, Illinois 60637.
M
M
Bibbo
D H
DH
Kim
H
H
Galera-Davidson
C
C
di Loreto
H E
HE
Dytch
D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology* / Q000648:ultrastructure; D002467:Cell Nucleus / Q000648:ultrastructure; D003936:Diagnosis, Computer-Assisted; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D010783:Photometry; D010865:Pilot Projects; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000648:ultrastructure