Histologic and morphometric grading of gliomas. A comparative survival analysis.
OBJECTIVE
A grading system based upon morphometrically assessed quantitative parameters (HOM system) was correlated with the results of classical histologic grading (St. Anne/Mayo system [SAMS], 1988, and World Health Organization classification, 1993). Validation was done by comparison with survival data.


METHODS
This retrospective study consisted of representative paraffin-embedded tissue sections of 139 adults who had been surgically treated for supratentorial common gliomas between 1988 and 1994. Histologic grading diagnoses were adapted to the latest standard. Computer-assisted image analysis of Ki-67 (MIB1)/ Feulgen-stained sections provided nuclear parameters appropriate to define homogeneous grades of malignancy by multivariate statistical analyses: average segment length of the minimum spanning trees (ASLMST) for the quantitation of tumor growth pattern; nuclear area percentage (NAP), reflecting cellularity; and volume-weighted mean nuclear volumes (vV) for estimating nuclear size and pleomorphism.


RESULTS
Analysis of survival data yielded no statistically significant differences between astrocytomas and oligoastroacytomas (Lee-Desu test, alpha = 5%). Furthermore, only two prognostically different grades could be established, "low grade" and "high grade" gliomas, with the first representing SAMS grades 2 and 3 and the latter SAMS grade 4 (alpha = .1%). The same applied to HOM grades (alpha = .1%). Cox regression analysis of survival data demonstrated that histologic grading diagnoses and NAP tallied best with patients' outcome.
Niedermayer
I
I
Department of Neuropathology, University of the Saarland, Homburg, Germany.
Kolles
H
H
Feiden
W
W
D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000737:chemistry / Q000401:mortality* / Q000473:pathology*; D002467:Cell Nucleus / Q000737:chemistry / Q000473:pathology; D005260:Female; D005910:Glioma / Q000737:chemistry / Q000401:mortality* / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D008433:Mathematics; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate
D019394:Ki-67 Antigen