The role of nuclear morphometry in prediction of prognosis for rhabdomyosarcoma in children.
OBJECTIVE
To determine whether nuclear morphometry can be used in pretreatment diagnostic procedures to guide the therapy of childhood rhabdomyosarcoma (RMS).


METHODS
Biopsy specimens obtained from 108 patients with rhabdomyosarcoma aged between 1 and 217 months treated in 12 paediatric oncology departments in Poland were evaluated. There were 65 (60.2%) specimens of embryonal rhabdomyosarcoma (RME), 32 (29.6%) of alveolar RMS (RMA) and 11 (10.2%) cases of undifferentiated RMS (RMU). The clinical data from all analysed patients were evaluated. Nuclear morphometry was performed semiautomatically on haematoxylin-eosin-stained sections using the MultiScan v.8.08 Computer Scanning System and an Olympus BX 50 microscope with a x 40 magnification lens.


RESULTS
In the RMA subtype cells with spindle-shape nuclei were less common (P = 0.013) and cell nuclei were generally more round in comparison with RME (P = 0.033). The clinical outcome was better if the nuclei seen in biopsies of RMS were more spindle-shaped (event-free survival 0.51 and 0.23, respectively; P = 0.04) or more cells with spindle-shaped nuclei were observed (event-free survival 0.5 and 0.28, P = 0.035). RME patients with small nuclei had a better outcome then patients with large nuclei (P = 0.014). In the RMA/RMU group, patients with small tumour cell nuclei had a worse prognosis than patients with larg tumour cell nuclei (P = 0.046).


CONCLUSIONS
Nuclear morphometry is a useful tool in the assessment of children with RMS. Additionally, certain morphometric parameters could be easily applied in a selection of patients with good prognosis.
Department of Bone Marrow Transplantation, Paediatric Oncology and Haematology, Wroclaw Medical University, Wroclaw, Poland. kazanowska@wp.pl
B
B
Kazanowska
M
M
Jelen
A
A
Reich
W
W
Tarnawski
A
A
Chybicka
D014408:Biomarkers, Tumor / Q000032:analysis*; D002467:Cell Nucleus; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D008297:Male; D011379:Prognosis; D012208:Rhabdomyosarcoma / Q000401:mortality / Q000473:pathology*; D016019:Survival Analysis
D014408:Biomarkers, Tumor