Improving the prognostic value of histopathological grading and clinical staging in renal cell carcinomas by means of computer-assisted microscopy.
The present work aims to refine prognosis in cases of renal cell carcinoma (RCC) by integrating a variety of parameters with the prognostic information provided by histopathological grading and clinical staging, carried out on a series of 97 RCCs. To this end, Feulgen-stained RCC cell nuclei were characterized by means of 38 variables describing nuclear DNA ploidy levels and morphology. All of these data were subjected to a principal components analysis. On the basis of this multivariate analysis, Fuhrman grade II was subdivided into grades II- and II+, and Fuhrman grade III into grade III- and III+. The same kind of subcategorization was performed in the case of the T2 and T3 clinical stages. The results show that the classification into grade II- and III- RCCs correspond to a more favourable prognosis than grade II+ and III+, to which shorter survival periods were attributable. Similar results were obtained for the subcategorization of the T2 and T3 clinical stages. Very simple biological characterizations of these grade- or stage-related RCC groups were obtained by means of a decision tree approach applied to the cytometry-generated variables. The resulting classification rules were validated on a new series of 18 patients and enabled very accurate predictions of survival.
François
C
C
Laboratory of Histology, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium.
Decaestecker
C
C
De Lathouwer
O
O
Moreno
C
C
Peltier
A
A
Roumeguere
T
T
Danguy
A
A
Pasteels
J L
JL
Wespes
E
E
Salmon
I
I
van Velthoven
R
R
Kiss
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000473:pathology*; D004396:Coloring Agents; D003663:Decision Trees; D005260:Female; D006801:Humans; D019044:Image Cytometry; D007091:Image Processing, Computer-Assisted; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011003:Ploidies; D011379:Prognosis; D012394:Rosaniline Dyes; D015996:Survival Rate
D004396:Coloring Agents; C007722:Feulgen stain; D012394:Rosaniline Dyes