title: Intratumor heterogeneity of morphometric and stereologic variables in primary ovarian tumors and their omental metastatic deposits.
abstract: OBJECTIVE
  To compare quantitative pathologic variables assessed in primary ovarian tumors and metastatic tumor deposits in the omentum and compare their prognostic value.
  
  
  METHODS
  In 29 cases of advanced ovarian cancer the mean nuclear area (MNA), volume-weighted mean nuclear volume (vv), volume percentage epithelium (VPE) and mitotic activity index (MAI) were assessed in both the primary ovarian tumor and its metastatic deposits in the omentum. Differences were evaluated using the Wilcoxon rank sum test for paired observations, and coefficients of variation were calculated in each case over the values obtained from the tumor in the ovary and omentum.
  
  
  RESULTS
  Intraobserver and interobserver reproducibility of MNA, VPE and MAI were all good to very good except for the interobserver reproducibility for vv, which was moderate. MNA and vv, correlated well, both in the primary ovarian tumor (r = .88) and omental metastasis (r = .87). No significant differences were found between the assessments of MNA, vv, and MAI in the primary ovarian tumor and its omental metastasis, whereas significant differences were found for VPE. However, in some patients the nuclei tended to be larger and the VPE lower in the omental metastasis than in the primary ovarian tumor. No important impact of the origin of tumor tissue was reflected in the prognostic value of the nuclear features. Patients were grouped prognostically differently for the assessment of MAI and VPE in the primary ovarian tumor and its omental metastasis.
  
  
  CONCLUSIONS
  Quantitative pathologic variables for prognostic purposes are best assessed in the primary ovarian tumor. Measurements in the metastatic deposits may be helpful in understanding processes of metastasis in advanced ovarian cancer.
authors.affiliation: Department of Pathology, Free University Hospital, Amsterdam, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Brinkhuis
authors.forename: C
authors.initials: C
authors.lastname: Scheepstra
authors.forename: M R
authors.initials: MR
authors.lastname: Buist
authors.forename: P J
authors.initials: PJ
authors.lastname: van Diest
authors.forename: J P
authors.initials: JP
authors.lastname: Baak
mesh_terms: D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009852:Omentum / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000473:pathology*; D010534:Peritoneal Neoplasms / Q000473:pathology* / Q000556:secondary*; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D016019:Survival Analysis