title: Improved prediction of metastasis in tongue carcinomas, combining vascular and nuclear tumor parameters.
abstract: BACKGROUND
  Predicting the presence of metastasis, based on tumor or tumor-related characteristics is of utmost importance. The authors studied the significance of tumor DNA features and tumor-related angiogenesis to predict the occurrence of metastasis in squamous cell carcinomas (SCCs) of the tongue.
  
  
  METHODS
  Paraplast blocks from resection specimens of 20 metastasized and 20 nonmetastasized SCCs of the tongue with a minimum follow-up of 24 months were used. Tissue sections were stained with anti-CD34 monoclonal antibodies for vessel visualization, and according to Feulgen to stain DNA. Using image analysis, data from both stainings were computed for each of the 40 carcinomas. A logistic regression model to predict the presence of metastasis, based on vascular and nuclear morphology features, was developed.
  
  
  RESULTS
  The intratumor variation of chromatin condensation and the percentage vessels smaller than 5 microm in diameter were selected for the model. The model correctly predicted metastasis in 90% of patients and excluded metastasis correctly in 75% of nonmetastasized tumors. Taking into account the prevalence of metastasis in SCC of the tongue of between 30% and 60%, this means a predictive value for a negative outcome of between 95% and 83%.
  
  
  CONCLUSIONS
  The proposed model shows an improvement of predictive values compared with previous models with single parameters. Therefore, a multiparameter model appears to predict the multiparameter process of metastasis better.
authors.affiliation: Department of Pathology, University Medical Centre St. Radboud Nijmegen, Nijmegen, The Netherlands. ehan@mkg.azm.nl
authors.forename: E J
authors.initials: EJ
authors.lastname: Hannen
authors.forename: J A
authors.initials: JA
authors.lastname: van der Laak
authors.forename: J J
authors.initials: JJ
authors.lastname: Manni
authors.forename: M M
authors.initials: MM
authors.lastname: Pahlplatz
authors.forename: H P
authors.initials: HP
authors.lastname: Freihofer
authors.forename: P J
authors.initials: PJ
authors.lastname: Slootweg
authors.forename: R
authors.initials: R
authors.lastname: Koole
authors.forename: P C
authors.initials: PC
authors.lastname: de Wilde
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000098:blood supply / Q000473:pathology* / Q000648:ultrastructure; D002467:Cell Nucleus; D002843:Chromatin; D006801:Humans; D016015:Logistic Models; D009362:Neoplasm Metastasis / Q000473:pathology; D009389:Neovascularization, Pathologic; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014062:Tongue Neoplasms / Q000098:blood supply / Q000473:pathology* / Q000648:ultrastructure
chemical_list: D002843:Chromatin