Value of morphometric nuclear image analysis using the Feulgen reaction in renal cell carcinoma.
OBJECTIVE
To evaluate retrospectively the ability of morphometric nuclear image analysis to predict survival in patients with renal cell carcinoma.


METHODS
The subjects were 40 patients with previously untreated renal cell carcinoma. Pathologic stage was determined using Robson's stage system. Nuclear grade was assigned according to the criteria of Fuhrman et al. We used the Feulgen staining technique, which has been widely used for the histochemical assessment of nuclear DNA content. A minimum of 300 nuclei were analyzed from each subject. Five variables in morphometric nuclear image analysis were measured: nuclear area, nuclear perimeter, nuclear ellipticity, nuclear regularity and DNA content. Cox's proportional hazard model was applied to identify prognostic usefulness with respect to survival time.


RESULTS
All nuclear morphometric variables but nuclear regularity correlated with tumor grade. According to univariate survival analyses, Robson stage and nuclear ellipticity revealed a prognosis on survival with statistical significance. After adjustments for age and sex, nuclear ellipticity remained the only significant prognostic factor related to survival (P < .01). The survival rates were relatively high for patients with nuclear ellipticity > 773 as compared to those with nuclear ellipticity < 773 (P < .05).


CONCLUSIONS
These findings indicate that morphometric nuclear image analysis using the Feulgen reaction is a reliable and efficient technique and that nuclear ellipticity is the most discriminating morphometric variable for predicting the prognosis of renal cell carcinoma patients.
Lee
J S
JS
Department of Pathology, Seonam University, College of Medicine, Namwon, Korea.
Jung
J J
JJ
Lee
M C
MC
Park
C S
CS
Juhng
S W
SW
Oh
B R
BR
Moon
J D
JD
D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000235:genetics / Q000473:pathology / Q000648:ultrastructure*; D002467:Cell Nucleus / Q000235:genetics / Q000473:pathology / Q000648:ultrastructure; D004396:Coloring Agents; D004247:DNA / Q000032:analysis; D005069:Evaluation Studies as Topic; D005260:Female; D006651:Histocytochemistry; D006801:Humans; D019044:Image Cytometry / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007680:Kidney Neoplasms / Q000235:genetics / Q000473:pathology / Q000648:ultrastructure*; D008297:Male; D008867:Microtomy; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012394:Rosaniline Dyes; D013194:Staining and Labeling; D015996:Survival Rate
D004396:Coloring Agents; C007722:Feulgen stain; D012394:Rosaniline Dyes; D004247:DNA