Absence of prognostic value of nuclear shape factor analysis in colorectal carcinoma: relevance of interobserver and intraobserver variability.
OBJECTIVE
Several retrospective studies, including our previous investigation, have shown a prognostic value of nuclear shape factor in colorectal carcinomas. This prospective study was designed to assess the reliability of nuclear shape factor determined by nuclear morphometry and to confirm its prognostic value.


METHODS
Ninety-eight patients who underwent colorectal carcinoma resection were prospectively enrolled. Measurement of nuclear shape factor was performed by using a computer-based image analysis system. Nuclear shape factor was defined as the degree of circularity of the nucleus (1.0 for a perfect circle and <1.0 for any other elliptical shape). The prognostic impact of nuclear shape factor on ten-year survival and the intraobserver and interobserver agreement were assessed.


RESULTS
The nuclear shape factor mean values by American Joint Committee on Cancer stage were: 0.73 (0.07) in Stage I, 0.74 (0.06) in Stage II, and 0.75 (0.05) in Stage III carcinomas (P = 0.78, ANOVA). The intraobserver agreement was poor for observer A (r = 0.28) and practically nonexistent for observer B (r = -0.004, Pearson correlation). The intraclass coefficient for interobserver agreement was practically nonexistent. No significant association between nuclear shape factor and ten-year survival was found.


CONCLUSIONS
Our prospective results, as opposed to our previous retrospective results, suggest that the reliability for nuclear shape factor morphometric analysis is very poor. We failed to confirm a prognostic value for nuclear shape factor in colorectal carcinoma.
Di Fabio
Francesco
F
Division of Colon and Rectal Surgery, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Quebec, Canada.
Shrier
Ian
I
Bégin
Louis R
LR
Gordon
Philip H
PH
D002277:Carcinoma / Q000175:diagnosis*; D053144:Cell Nucleus Shape; D003110:Colonic Neoplasms / Q000175:diagnosis*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D009367:Neoplasm Staging; D015588:Observer Variation; D011237:Predictive Value of Tests; D011379:Prognosis; D012004:Rectal Neoplasms / Q000175:diagnosis*; D015203:Reproducibility of Results; D015996:Survival Rate