title: Prognostic evaluation of morphonuclear parameters in superficial and invasive bladder cancer.
abstract: OBJECTIVE
  To assess the prognostic value of morphonuclear parameters determined by means of computerized image analysis in untreated bladder tumours.
  
  
  METHODS
  Fifty patients had untreated bladder cancer; in 28 patients the tumours were superficial (7pT1G1; 14pT1G2; 7pT1G3) and in 22 they were invasive (6T2G2, 9T2G3, 2T3G2, 5T3G3). Feulgen-stained imprints were processed for morphonuclear analysis on a SAMBA 200 computerized image analysis system (T1TN, France), which measures optical density (integrated optical density, IOD; surface area, SURF; mean optical density, MOD), texture (long run length, LRL; short run length, SRL; run length distribution, RLD; run length percentage, RLP; grey level distribution, GLD) and contrast (contrast, C; energy, E).
  
  
  RESULTS
  Morphonuclear parameters IOD, SURF, LRL, SRL and C were found to correlate with the risk of recurrence and progression of superficial bladder tumours (results for ANOVA respectively IOD P < 0.001; SURF P = 0.02; LRL P = 0.05; RLD P = 0.04; SRL P = 0.04; C P < 0.001). In invasive bladder cancer, parameters IOD and C only correlated with the risk of progression (ANOVA respectively IOD P < 0.001; C P < 0.001). On the other hand, progression-free curve analysis using the Kaplan Meier method showed that morphonuclear parameters may be useful in predicting the outcome for superficial tumours (Log/Rank test: SURF P < 0.001; RLD < 0.001; SRL = 0.003; LRL < 0.001; C < 0.001; IOD < 0.001). In the case of invasive tumours, only two parameters provided prognostic information (Logrank test: C < 0.001; IOD < 0.001).
  
  
  CONCLUSIONS
  Nuclear morphometry assessed by image analysis is potentially useful in assessing the prognosis of bladder tumours; it provides objective and quantitative parameters. Further studies will determine whether morphonuclear analysis can be used to monitor the treatment of bladder cancer, particularly superficial tumours.
authors.affiliation: Service d'Urologie, CHU Henri Mondor, Creteil, France.
authors.forename: M
authors.initials: M
authors.lastname: Colombel
authors.forename: Y
authors.initials: Y
authors.lastname: De Launoit
authors.forename: J
authors.initials: J
authors.lastname: Bellot
authors.forename: R
authors.initials: R
authors.lastname: Kiss
authors.forename: C
authors.initials: C
authors.lastname: Abbou
authors.forename: D
authors.initials: D
authors.lastname: Chopin
mesh_terms: D000704:Analysis of Variance; D018450:Disease Progression; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology*