Prognostic significance of nuclear morphometry in renal cell carcinoma.
OBJECTIVE
To assess nuclear morphometry as a predictor of prognosis in patients with renal cell carcinoma (RCC).


METHODS
The study included 65 consecutive patients with RCC who underwent radical nephrectomy and were followed up for a median (range) of 80 (27-138) months. Nuclear morphometry was assessed using a computer-assisted image analysis system on histological sections and characterized by five nuclear variables (area, perimeter, major and minor diameter, and form factor). From the patients' records and pathology specimens, the clinicopathological prognostic variables (histological type, Fuhrman grade and pathological stage) were recorded. The proliferative activity was assessed using immunohistochemical staining with Ki-67 antibody.


RESULTS
Higher values of mean nuclear area, perimeter, and major and minor diameter were significantly related to higher nuclear grade, proliferative activity and advanced tumour stage. They were significant predictors of disease progression and survival, together with grade, stage, sarcomatoid histology and proliferative activity. Of all significant prognostic factors predicting progression-free survival, only stage was independent (T4 vs T1, hazard ratio 6.55, 95% CI 1.63-26.13, P=0.008).


CONCLUSIONS
Although the significance of these preliminary results must not be overstated, nuclear morphometry might provide significant prognostic information in predicting survival and tumours at high risk of progression in RCC.
Ozer
E
E
Department of Pathology, Dokuz Eylül University School of Medicine, Inciralti, Izmir, Turkey.
Yörükoğlu
K
K
Sagol
O
O
Mungan
U
U
Demirel
D
D
Tüzel
E
E
Kirkali
Z
Z
D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000648:ultrastructure*; D002455:Cell Division; D002467:Cell Nucleus / Q000473:pathology*; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis; D007680:Kidney Neoplasms / Q000648:ultrastructure*; D008297:Male; D008875:Middle Aged; D011379:Prognosis
D019394:Ki-67 Antigen