1
|
PREDICTING PATHOLOGICAL STAGE OF LOCALIZED PROSTATE CANCER USING VOLUME WEIGHTED MEAN NUCLEAR VOLUME. J Urol 2000. [DOI: 10.1097/00005392-200011000-00029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
2
|
PREDICTING PATHOLOGICAL STAGE OF LOCALIZED PROSTATE CANCER USING VOLUME WEIGHTED MEAN NUCLEAR VOLUME. J Urol 2000. [DOI: 10.1016/s0022-5347(05)67034-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
3
|
THE ROLE OF VOLUME WEIGHTED MEAN NUCLEAR VOLUME IN PREDICTING THE PROGNOSIS OF PATIENTS WITH PRIMARY TRANSITIONAL CELL CARCINOMA OF THE UPPER URINARY TRACT: A REPORT OF 102 NEW CASES. J Urol 2000. [DOI: 10.1097/00005392-200008000-00019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
4
|
FUJIKAWA KEITA, MATSUI YOSHIYUKI, OKA HIROYA, FUKUZAWA SHIGEKI, SASAKI MIHARU, TAKEUCHI HIDEO. THE ROLE OF VOLUME WEIGHTED MEAN NUCLEAR VOLUME IN PREDICTING THE PROGNOSIS OF PATIENTS WITH PRIMARY TRANSITIONAL CELL CARCINOMA OF THE UPPER URINARY TRACT: A REPORT OF 102 NEW CASES. J Urol 2000. [DOI: 10.1016/s0022-5347(05)67358-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- KEITA FUJIKAWA
- From the Department of Urology, Kobe City General Hospital, Chuo-ku, Kobe City, and Department of Urology, Shizuoka City Hospital, Shizuoka City, Japan
| | - YOSHIYUKI MATSUI
- From the Department of Urology, Kobe City General Hospital, Chuo-ku, Kobe City, and Department of Urology, Shizuoka City Hospital, Shizuoka City, Japan
| | - HIROYA OKA
- From the Department of Urology, Kobe City General Hospital, Chuo-ku, Kobe City, and Department of Urology, Shizuoka City Hospital, Shizuoka City, Japan
| | - SHIGEKI FUKUZAWA
- From the Department of Urology, Kobe City General Hospital, Chuo-ku, Kobe City, and Department of Urology, Shizuoka City Hospital, Shizuoka City, Japan
| | - MIHARU SASAKI
- From the Department of Urology, Kobe City General Hospital, Chuo-ku, Kobe City, and Department of Urology, Shizuoka City Hospital, Shizuoka City, Japan
| | - HIDEO TAKEUCHI
- From the Department of Urology, Kobe City General Hospital, Chuo-ku, Kobe City, and Department of Urology, Shizuoka City Hospital, Shizuoka City, Japan
| |
Collapse
|
5
|
Kanamaru H, Zhang YH, Takahashi M, Nakamura N, Ishida H, Akino H, Muranaka K, Okada K. Analysis of the mechanism of discrepant nuclear morphometric results comparing preoperative biopsy and prostatectomy specimens. Urology 2000; 56:342-5. [PMID: 10925120 DOI: 10.1016/s0090-4295(00)00583-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To explore the mechanism for the differing nuclear morphometric results between needle biopsy and surgical specimens of the prostate. METHODS In experiment 1, a comparison of mean nuclear area (MNA), volume-weighted mean nuclear volume (MNV), and form factor (FF) for prostatic epithelial cells was performed between preoperative needle biopsy and prostatectomy specimens from 5 patients with benign prostatic hyperplasia (BPH). In experiment 2, a scheduled, sequential ex vivo needle sampling from the enucleated prostates (at 0, 2, 6, and 24 hours after surgical resection) was also performed for 7 patients with BPH. The prostatectomy specimens were left unfixed for 2 hours until the second needle sampling was done. Nuclear morphometric parameters were measured on the needle-sampled as well as on the prostatectomy specimens. RESULTS MNA, MNV, and FF of BPH cells measured on preoperative biopsy specimens were smaller than those of surgical specimens in all 5 of the cases. The results of nuclear morphometry on the materials obtained by ex vivo needle sampling of prostates before and during fixation revealed that the MNA, MNV, and FF for BPH cells of 0-hour specimens were significantly smaller than those for needle samples at 2, 6, and 24 hours after surgical resection as well as those for prostatectomy specimens. CONCLUSIONS The present study provided further evidence that the ischemic damage caused by delayed fixation could result in a substantial change of the nuclear morphology of prostate cells. An immediate start, as well as a rapid completion, of the fixation procedure seems critical for an accurate nuclear morphometry of prostatectomy specimens.
Collapse
Affiliation(s)
- H Kanamaru
- Department of Urology, Fukui Medical University, Fukui, Japan
| | | | | | | | | | | | | | | |
Collapse
|
6
|
Zhang YH, Kanamaru H, Oyama N, Miwa Y, Suzuki Y, Akino H, Noriki S, Okada K. Prognostic value of nuclear morphometry on needle biopsy from patients with prostate cancer: is volume-weighted mean nuclear volume superior to other morphometric parameters? Urology 2000; 55:377-81. [PMID: 10699614 DOI: 10.1016/s0090-4295(99)00456-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
OBJECTIVES To compare the prognostic value of stereologically estimated volume-weighted mean nuclear volume (MNV) with other nuclear morphometric parameters using pretreatment needle-biopsy specimens of prostate cancer. METHODS The MNV, mean nuclear area, form factor, and coefficients of variation for nuclear area (VNA) and form factor were measured on pretreatment needle biopsy specimens from 66 patients with prostate cancer (clinical Stage B, n = 9; Stage C, n = 14; and Stage D, n = 43), all of whom underwent androgen deprivation therapy. The prognostic value of those morphometric parameters, as well as Gleason score and clinical stage, was examined in terms of cause-specific patient survival using univariate and multivariate analysis (Cox proportional hazard model). RESULTS Univariate analysis of the nuclear morphometric parameters revealed that MNV, mean nuclear area, VNA, coefficient of variation for form factor, and clinical stage were significant prognostic factors for cause-specific patient survival. However, when the patients with Stage D disease were selectively analyzed for survival, only the VNA was a significant prognostic parameter. Furthermore, the multivariate analysis, including the morphometric parameters, clinical stage, and Gleason score revealed that only VNA and clinical stage were independent variables. CONCLUSIONS The present comparative study could not demonstrate any prognostic superiority of MNV over other nuclear morphometric parameters in patients with prostate cancer.
Collapse
Affiliation(s)
- Y H Zhang
- Department of Urology, Fukui Medical University, Fukui, Japan
| | | | | | | | | | | | | | | |
Collapse
|
7
|
Fujikawa K, Itoh T, Nishio Y, Miyakawa M, Sasaki M. The role of volume-weighted mean nuclear volume in predicting disease outcome in patients with prostate cancer treated with radical prostatectomy. APMIS 1999; 107:773-8. [PMID: 10515128 DOI: 10.1111/j.1699-0463.1999.tb01472.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Estimates of volume-weighted mean nuclear volume (MNV) are the only means by which unbiased estimates of three-dimensional parameters can be obtained from single two-dimensional sections without any assumptions. We have reported that for prostate cancer estimates of MNV are prognostically equal or superior to morphological grading of malignancy, such as Gleason score (GS), and in particular, that MNV proved to be a meaningful predictor of prognosis for patients with clinically localized tumors. However, all previous studies were conducted on patients treated conservatively, and no authors have tested whether estimates of MNV can predict the prognosis of patients treated with radical prostatectomy. MATERIALS AND METHODS A retrospective prognostic study of 52 patients with clinically localized prostate cancer diagnosed at three Hospitals in Shizuoka Prefecture, Japan (Shizuoka City Hospital, Shizuoka Prefectural Hospital and Shimada Municipal Hospital) and treated by radical prostatectomy was performed. Twenty of these patients were treated with hormone therapy before radical prostatectomy. Unbiased estimates of MNV were compared with clinical stage, histological grading according to GS and neo-adjuvant hormone therapy with regard to the prognostic value. RESULTS MNV was significantly correlated with pathological T stage, but was not significantly correlated with the presence or absence of lymph node metastasis. Univariate analysis revealed that MNV correlated significantly with progression-free survival (p = 0.0116). Multivariate analysis revealed that MNV (p = 0.0115) and GS (p = 0.0275) were two significant independent predictors of progression-free survival. CONCLUSIONS The results of the present study suggest that MNV and GS are powerful independent predictors of prognosis for prostate cancer treated with radical prostatectomy. We recommend estimates of MNV as a supportive method to the histological grading for patients with prostate cancer.
Collapse
Affiliation(s)
- K Fujikawa
- Department of Urology, Kobe City General Hospital, Japan
| | | | | | | | | |
Collapse
|
8
|
Fujikawa K, Aoyama T, Itoh T, Nishio Y, Miyakawa M, Sasaki M. The role of volume-weighted mean nuclear volume in predicting disease outcome in patients with stage M1 prostate cancer. APMIS 1999; 107:395-400. [PMID: 10230693 DOI: 10.1111/j.1699-0463.1999.tb01571.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Various factors have been reported to be of value in predicting the prognosis of prostate cancer. Gleason score (GS) and prostate-specific antigen (PSA) are the two most powerful prognosticators among them. We previously reported that estimation of volume-weighted mean nuclear volume (MNV) was a more useful prognosticator for prostate cancer than subjective histologic grading. In this study, we compared estimates of MNV with PSA and GS for predicting the prognosis of stage M1 prostate cancer. EXPERIMENTAL DESIGN A retrospective prognostic study of 66 patients with stage M1 prostate cancer diagnosed between January 1989 and December 1996 at Shizuoka City Hospital and Shizuoka Prefectural Hospital was performed. The prognostic value of unbiased estimates of MNV were compared with PSA and histologic grading according to GS. RESULTS Univariate analysis revealed that estimates of MNV (p=0.0136) and post-treatment nadir PSA level (p<0.0001) correlated significantly with the prognosis of stage M1 prostate cancer, whilst GS (p=0.9377), pre-treatment PSA level (p=0.7377) and rate of decrease in PSA level within 1 month after the beginning of therapy (p=0.8999) had no prognostic value. Multivariate analysis revealed that post-treatment PSA level and estimates of MNV were the two most powerful prognosticators. CONCLUSIONS This study indicates that estimation of MNV is an important prognosticator, in conjunction with post-treatment nadir PSA level, in stage M1 prostate cancer.
Collapse
Affiliation(s)
- K Fujikawa
- Department of Urology, Kobe City General Hospital, Japan
| | | | | | | | | | | |
Collapse
|
9
|
Kanamaru H, Sasaki M, Miwa Y, Akino H, Okada K. Prognostic value of sarcomatoid histology and volume-weighted mean nuclear volume in renal cell carcinoma. BJU Int 1999; 83:222-6. [PMID: 10233484 DOI: 10.1046/j.1464-410x.1999.00912.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the prognostic value of two histopathological factors, sarcomatoid histology and volume-weighted mean nuclear volume (MNV) in renal cell carcinoma (RCC). PATIENTS AND METHODS The study included 106 patients (72 men and 34 women, mean age 63 years, range 32-83) with RCC, all of whom were surgically treated between 1985 and 1995. The presence of any sarcomatoid component was determined and MNV estimated using a stereological method in histological slides of tumour specimens from these patients. The prognostic significance of the two variables was evaluated by univariate and multivariate analyses in comparison with other histopathological variables (T, N and M categories, nuclear grade, tumour size, tumour type), using the cause-specific and progression-free survival of the patients as the endpoints. RESULTS Among the 106 RCC cases examined, a sarcomatoid component was detected in 34 (32%); the MNV was 90-627 micro3 (mean 225). By univariate and multivariate analysis, both variables were significant prognostic factors for cause-specific survival in all patients. In addition, multivariate analysis of the 74 patients with localized RCCs (T1-3, N0 M0) showed that sarcomatoid histology was a significant prognostic factor for disease progression. CONCLUSION The presence of sarcomatoid histology and the MNV, both of which can be examined with no specialized laboratory procedures, seem to be useful tumour-related prognostic factors in RCC.
Collapse
Affiliation(s)
- H Kanamaru
- Department of Urology, Fukui Medical University, Shizuoka City Hospital, Japan
| | | | | | | | | |
Collapse
|
10
|
Binder M, Steiner A, Mossbacher U, Hunegnaw M, Pehamberger H, Wolff K. Estimation of the volume-weighted mean nuclear volume discriminates keratoacanthoma from squamous cell carcinoma. Am J Dermatopathol 1998; 20:453-8. [PMID: 9790104 DOI: 10.1097/00000372-199810000-00004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Keratoacanthoma (KA) is a fairly common neoplasm that in the past has been considered by many to be benign. Keratoacanthoma is usually differentiated from squamous cell carcinoma (SCC) by histopathologic criteria. However, the cytologic features of KA and SCC are often similar. Hence, KA may be confused with SCC at the histopathologic level. Volume-weighted mean nuclear volume (Vv) is determined by a technique that permits an unbiased and efficient estimation of nuclear volumes in tissues without any assumptions regarding nuclear shape. In this study, the volume-weighted mean nuclear volume was determined in 18 KAs and 19 SCCs to investigate whether this stereologic approach may be of use in the differentiation of these two tumors. Vv was determined by computer-assisted image analysis (IBAS 20, Kontron, Germany) on Feulgen-stained sections employing stereologic estimation of the volume-weighted mean nuclear volume. The mean Vv of KA was 704.5 microm3 (SD +/-170.5), whereas SCC exhibited a significantly lower Vv of 533.9 microm3 (SD+/-164.9) (p = 0.006). The sensitivity and specificity of Vv for the discrimination between KA and SCC was 0.80 and 0.78, respectively. We found that KAs show a significantly larger Vv than SCCs and thus, the estimation of the volume-weighted mean nuclear volume may be regarded as a helpful tool for the differential diagnosis of KA and SCC.
Collapse
Affiliation(s)
- M Binder
- Department of Dermatology, University of Vienna Medical School, Austria
| | | | | | | | | | | |
Collapse
|
11
|
Fujikawa K, Sasaki M, Itoh T, Arai Y, Ogawa O, Yoshida O. Combining volume-weighted mean nuclear volume with Gleason score and clinical stage to predict more reliably disease outcome of patients with prostate cancer. Prostate 1998; 37:63-9. [PMID: 9759699 DOI: 10.1002/(sici)1097-0045(19981001)37:2<63::aid-pros1>3.0.co;2-m] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Various criteria for patients with prostate cancer have been reported to be of prognostic value, and we have reported that estimates of volume-weighted mean nuclear volume (MNV), developed by Gundersen and Jensen based on a stereological technique, accurately predict the prognosis of prostate cancer. However, all of these studies were conducted on cases in a single institution, and it has remained unclear whether MNV calculations obtained at one institution apply to cases at another institution. In attempting to solve this problem, we made a prognostic index (P.I.) based on data from one hospital, and tested whether these data could be used to predict the prognosis of patients at another hospital. MATERIALS AND METHODS A retrospective, multivariate prognostic study of 195 patients with prostate cancer, diagnosed at Kyoto University Hospital and treated conservatively, indicated that clinical stage, Gleason score, and MNV were all significantly correlated with the prognosis of patients with prostate cancer. From the relative strengths of these prognostic factors in a multivariate analysis, the following P.I. was constructed: P.I. = Clinical stage x 1.8040 + Gleason score x 1.5245 + MNV x 2.3162 (the constants correspond to the risk ratio estimated by Cox analysis). The P.I. was calculated for 104 patients with prostate cancer diagnosed at Shizuoka City Hospital and treated conservatively for analysis of disease-specific survival. RESULTS The prognostic index ranged from 3.841-16.142. Using the median value of 12.5 as a cutoff point, a clear separation of cases with poor and favorable prognosis was achieved (P < 0.0001, observation period: 1-167 months). CONCLUSIONS The results of this study suggest that estimates of MNV can be evaluated at multiple institutions with the use of P.I. calculation. Furthermore, combining estimates of MNV with Gleason score and clinical stage predicts most powerfully disease outcome of patients with prostate cancer.
Collapse
Affiliation(s)
- K Fujikawa
- Department of Urology, Kobe City General Hospital, Japan.
| | | | | | | | | | | |
Collapse
|
12
|
Ogura K, Fukuzawa S, Habuchi T, Ogawa O, Yoshida O. Correlation of nuclear morphometry and immunostaining for p53 and proliferating cell nuclear antigen in transitional cell carcinoma of the bladder. Int J Urol 1997; 4:561-6. [PMID: 9477184 DOI: 10.1111/j.1442-2042.1997.tb00309.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND In an attempt to determine the biological significance of nuclear morphometric findings, measurements of mean nuclear volume (MNV) and nuclear roundness factor (NRF) were compared to the immunoreactivity of p53 expression and proliferating cell nuclear antigen (PCNA) in human bladder cancer. METHODS MNV and NRF were measured using stereological methods. Expression of p53 and PCNA were determined by immunohistochemical staining. Specimens from 111 patients with previously untreated bladder cancer were analyzed. RESULTS The mean MNV was 235.8 +/- 133.6 microm3 for the 81 patients with p53-labeling index (LI) less than 10% and 337.2 +/- 141.0 microm3 for the 30 patients with p53 LI greater than 10% (P = 0.008). There was no significant correlation between NRF and expression of p53. The mean MNV was 220.1 +/- 120.5 microm3 for the 67 patients with PCNA LI less than 28% (the mean value of PCNA LI) and 328.9 +/- 149.2 microm3 in 44 patients with PCNA LI greater than 28% (P = 0.0001). The mean NRF was 80.7 +/- 4.2 for the 67 patients with PCNA LI less than 28%, and 82.3 +/- 3.4 for the 44 patients with PCNA LI more than 28% (P = 0.04). CONCLUSION Nuclear morphometric findings may reflect the proliferative potential of cancer cells of the bladder, as indicated by findings of immunostaining for p53 and PCNA.
Collapse
Affiliation(s)
- K Ogura
- Department of Urology, Rakuwa-kai Otowa Hospital, Faculty of Medicine, Kyoto University, Japan
| | | | | | | | | |
Collapse
|
13
|
Kanamaru H, Mori H, Sasaki M, Fujikawa K, Akino H, Miwa Y, Okada K. Histologic characteristics of renal cell carcinomas with lymph node metastasis. Int J Urol 1997; 4:451-5. [PMID: 9354945 DOI: 10.1111/j.1442-2042.1997.tb00284.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND This study was conducted to determine if there are any specific histologic features that are associated with lymph node metastasis in renal cell carcinoma (RCC). METHODS TNM classification, histologic grade, mean nuclear volume, cell type, and histologic architecture of the tumors were evaluated in 66 patients who had undergone nephrectomy and lymphadenectomy for RCC. In the 18 patients with positive lymph node metastasis, both primary lesions and metastatic lymph nodes were evaluated. RESULTS Lymph node status was correlated with primary tumor stage, venous involvement, and distant metastasis. The tumor grade was higher, and the mean nuclear volume was larger, in both primary and metastatic lesions of RCCs with lymph node metastasis than in tumors with no metastasis. In primary lesions of RCCs with lymph node metastasis, clear cell, alveolar, or cystic patterns were observed less frequently, and granular or spindle/pleomorphic cells and papillary or solid patterns, were observed more frequently, as compared to those lesions without metastasis. Comparison between primary and metastatic lesions in individual patients revealed no significant difference in grade or mean nuclear volume. The development of new cell types or histologic architectures, which was not noted in the primary lesions, was also a rare event in the metastatic lesions. CONCLUSION Several characteristic histologic features, which may reflect the increased metastatic potential of the tumor, were observed in both primary and metastatic lesions in cases of RCC with lymph node metastasis. No substantial difference in histologic features was observed between the primary or metastatic lesions of individual patients.
Collapse
Affiliation(s)
- H Kanamaru
- Department of Urology, Fukui Medical School, Japan
| | | | | | | | | | | | | |
Collapse
|
14
|
Role of Volume Weighted Mean Nuclear Volume for Predicting Disease Outcome in Patients with Renal Cell Carcinoma. J Urol 1997. [DOI: 10.1016/s0022-5347(01)64934-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
15
|
Fujikawa K, Sasaki M, Aoyama T, Itoh T, Yoshida O. Intratumoral heterogeneity in prostate cancer demonstrated by volume-weighted mean nuclear volume. APMIS 1997; 105:322-8. [PMID: 9164477 DOI: 10.1111/j.1699-0463.1997.tb00577.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This study was conducted to investigate the degree of heterogeneity of the volume-weighted mean nuclear volume (MNV) calculated from radical prostatectomy specimens, and to evaluate how closely the MNV calculated from transrectal biopsy specimens reflected the overall malignancy. MNV was evaluated using 77 sections of histological specimens from 9 patients who underwent radical prostatectomy at Shizuoka City Hospital between January 1990 and December 1995. The MNV values calculated from radical prostatectomy specimens were compared with those calculated from preoperative transrectal biopsy specimens. MNV was judged to be homogeneous in six cases and heterogeneous in three cases. Of the heterogeneous cases, MNV calculated from the transrectal biopsy specimens was judged to be underestimated in 2 of 3 cases. This study shows that intratumoral heterogeneity of prostate cancer may affect clinical estimates of the grade of malignancy based on the MNV, and indicates the need for a sufficient number of specimens in order to evaluate the MNV by transrectal biopsy.
Collapse
Affiliation(s)
- K Fujikawa
- Department of Urology, Shizuoka City Hospital, Japan
| | | | | | | | | |
Collapse
|
16
|
Role of Volume Weighted Mean Nuclear Volume for Predicting Disease Outcome in Patients with Renal Cell Carcinoma. J Urol 1997. [DOI: 10.1097/00005392-199704000-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
17
|
Mora LB, Nicosia SV, Pow-Sang JM, Ku NK, Diaz JI, Lockhart J, Einstein A. Ancillary techniques in the followup of transitional cell carcinoma: a comparison of cytology, histology and deoxyribonucleic acid image analysis cytometry in 91 patients. J Urol 1996; 156:49-54; discussion 54-5. [PMID: 8648836 DOI: 10.1016/s0022-5347(01)65934-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE Voided urine and bladder washing cytology are used frequently in the evaluation of transitional cell carcinoma of the bladder. As part of an ongoing investigation we report on the role of deoxyribonucleic acid (DNA) image analysis cytometry as an adjunct to cytology in the followup of patients with transitional cell carcinoma. MATERIALS AND METHODS Urine cytology and image analysis cytometry were performed independently on aliquots of voided urine, catheterized urine or bladder washings from 91 patients with previous or active transitional cell carcinoma of the bladder, and the results were compared to those of concurrent biopsy and clinical followup. RESULTS Of 75 recurrent transitional cell carcinomas 42 were detected by cytology, while 63 and 64 were identified by image analysis cytometry and biopsy, respectively, for a sensitivity of 57, 84 and 85%, respectively. Combined cytology and image analysis cytometry detected 67 recurrences, for an overall sensitivity of 89%. Of 11 cases undetected by concurrent biopsy 9 had abnormal DNA histograms with transitional cell carcinoma at followup and 2 were DNA diploid but with grade 1 transitional cell carcinoma at followup. Of 12 cases undetected by image analysis cytometry 8 were grade 1 and 4 were grade 2 transitional cell carcinoma. CONCLUSIONS Urine cytology and image analysis cytometry detect most recurrent tumors. Their combined use is indicated in the followup of patients with bladder transitional cell carcinoma.
Collapse
Affiliation(s)
- L B Mora
- Department of Pathology, University of South Florida College of Medicine, Tampa 33612, USA
| | | | | | | | | | | | | |
Collapse
|
18
|
|
19
|
Harnden P, Parkinson M. Transitional cell carcinoma of the bladder: diagnosis and prognosis. ACTA ACUST UNITED AC 1996. [DOI: 10.1016/s0968-6053(96)80014-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
20
|
Abstract
The components of the cell and tissue changes in many diseases are variable and can therefore be quantified. Characterization of these quantitative changes provides data that is useful not only for making a definitive, cell- and tissue-based diagnosis of disease, but also for predicting the course of disease. The spectrum of changes found in malignant tumors, ie, cell grade, architecture, cellularity, extent of invasion, nature and extent of inflammatory reaction, exemplify this range of quantifiable features. The diagnosis and prognosis of nonneoplastic diseases, ie, myopathy and metabolic bone disease, can also be determined by quantitating tissue changes. Morphometry is the quantification of changes in the "objects" of tissues, ie, cells and organelles, and their organization, using quantitative evaluation tools. The principles of morphometry have been known for a century. With the increasing availability of affordable, powerful computer systems and increasingly flexible and user-friendly software has come easier ability to measure these changes. This article discusses the principles of morphometry with illustrations of types of analysis (ie, area fraction, object counting, shape and size analyses, and mutliparametric analyses) using examples of these applications with discussions of error sources and limitations of morphometry.
Collapse
Affiliation(s)
- L D True
- Department of Pathology, University of Washington Medical Center, Seattle, 98195-6100, USA
| |
Collapse
|
21
|
Prognostic Criteria in Patients with Prostate Cancer. J Urol 1995. [DOI: 10.1097/00005392-199512000-00045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
22
|
Ladekarl M, Svanholm H. Significance of variations in section mounting technique for nuclear stereology and morphology in urinary bladder neoplasms. APMIS 1995; 103:892-6. [PMID: 8562030 DOI: 10.1111/j.1699-0463.1995.tb01449.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Owing to its toxicity it would be desirable to avoid xylene in the processing of histological tissue. Consequently, modifications of the section mounting technique excluding xylene have recently been suggested. Changes in tissue preparation might, however, influence histopathological structures used for malignancy grading of tumours. In the current study, we investigated the impact of alterations in the mounting process on the subjectively evaluated quality of nuclear morphology and on the stereologically obtained mean nuclear volume, vv(nuc), of urothelial neoplasms. Paraffin sections from 14 tumours were, after the haematoxylin-eosin staining, mounted with DPX and a coverslip either, 1) from the water bath, 2) after dehydration in ethanol but without clearing, or, 3) after dehydration and xylene clearing. We found that the nuclear morphology of ethanol-treated and xylene-cleared specimens was somewhat more brilliant than that of sections mounted from water. The vv(nuc) of xylene-cleared sections ranged from 142 to 751 microns3, and the mean value of 350 microns3 was not significantly different from that of ethanol-treated sections of 367 microns3 (2p = 0.67). In contrast, the mean vv(nuc) of sections mounted from water was 459 microns3, approximately 30% larger (2p < or = 0.02). Thus, although previous studies have demonstrated the prognostic value of vv(nuc) in patients with bladder cancer, the present study shows that modifications in section mounting technique may significantly influence the results, underscoring the need for standardization of tissue processing. Sections mounted from ethanol seem to be as good as routine xylene-cleared sections, whereas sections mounted from water have a less brilliant morphology and results of nuclear stereology different from those of routine sections.
Collapse
Affiliation(s)
- M Ladekarl
- Department of Pathology, University of Aarhus, Denmark
| | | |
Collapse
|
23
|
Fujikawa K, Sasaki M, Aoyama T, Itoh T, Yoshida O. Prognostic Criteria in Patients with Prostate Cancer: Correlation with Volume Weighted Mean Nuclear Volume. J Urol 1995. [DOI: 10.1016/s0022-5347(01)66712-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Keita* Fujikawa
- Departments of Urology and Pathology, Shizuoka City Hospital, Shizuoka City, and Department of Urology, Faculty of Medicine, Kyoto University Hospital, Kyoto City, Japan
| | - Miharu Sasaki
- Departments of Urology and Pathology, Shizuoka City Hospital, Shizuoka City, and Department of Urology, Faculty of Medicine, Kyoto University Hospital, Kyoto City, Japan
| | - Teruyoshi Aoyama
- Departments of Urology and Pathology, Shizuoka City Hospital, Shizuoka City, and Department of Urology, Faculty of Medicine, Kyoto University Hospital, Kyoto City, Japan
| | - Tadahiro Itoh
- Departments of Urology and Pathology, Shizuoka City Hospital, Shizuoka City, and Department of Urology, Faculty of Medicine, Kyoto University Hospital, Kyoto City, Japan
| | - Osamu Yoshida
- Departments of Urology and Pathology, Shizuoka City Hospital, Shizuoka City, and Department of Urology, Faculty of Medicine, Kyoto University Hospital, Kyoto City, Japan
| |
Collapse
|
24
|
Abstract
BACKGROUND Histologic grade and clinical stage generally are used for estimating the prognosis of bladder carcinoma. However, both methods have been reported to have a rather low reproducibility and to be unsatisfactory for predicting the recurrence and progression of superficial bladder carcinoma. Recently, nuclear morphometry was used to quantitate the malignant potential of cancer cells in a more objective and reproducible manner. The authors quantitatively analyzed the malignant potential of bladder carcinoma at initial presentation using a combination of several nuclear morphometric variables. METHODS The subjects were 156 patients with previously untreated bladder carcinoma. Three morphometric variables were measured in each subject: the mean nuclear volume (MNV), the nuclear roundness factor (NRF), and the variation of nuclear area (VNA). RESULTS Univariate analysis showed that MNV and NRF were significant prognostic indicators for survival (MNV, P < 0.0001; NRF, P = 0.008). In addition, MNV was a prognostic indicator for tumor recurrence (P = 0.001), whereas MNV and NRF were prognostic indicators for invasive progression (MNV, P = 0.02; NRF, P = 0.009). For accurate prediction of the prognosis of patients with bladder carcinoma, a prognostic score, a recurrence score, and a progression score were designed using the coefficients of MNV and NRF in a proportional hazards model. The prognostic score clearly divided the patients into two different groups with 5-year survival rates of 88% and 64% (P = 0.0002). In addition, patients with superficial bladder carcinoma and a low recurrence score had a significantly higher 5-year recurrence free rate than those with a high recurrence score (40% vs. 23%, P = 0.0004), and the 5-year progression free rate of patients with a low progression score was significantly higher than that of those with a high progression score (98% vs. 73%, P = 0.0006). CONCLUSIONS These findings suggest that nuclear morphometry is a reliable technique with which to identify prognostic indicators for human bladder carcinoma. A combination of several nuclear morphometric variables provides a more accurate indication of prognosis than any single parameter.
Collapse
Affiliation(s)
- S Fukuzawa
- Department of Urology, Faculty of Medicine, Kyoto University, Japan
| | | | | | | | | |
Collapse
|
25
|
Abstract
BACKGROUND Histologic grading, especially the Gleason score (GS), is considered to be of value in determining the prognosis of patients with prostate cancer. However, subjective histologic grading is characterized by low reproducibility. Conversely, estimates of mean nuclear volume (MNV), developed by Gunderson and Jensen based on a stereologic technique, is a method with high reproducibility. Furthermore, it has been reported that MNV provides an accurate prognosis of bladder cancer. In this study MNV was compared with two histologic grading methods in determining the prognosis of Stage D2 prostate cancer. METHODS A retrospective, prognostic study of 31 patients with Stage D2 prostate cancer treated with transurethral resection of the prostate or needle biopsy between January, 1983, and July, 1994, was performed. Unbiased estimates of MNV were compared with age at the time of diagnosis, histologic grading according to World Health Organization (WHO) classification, and GS on the prognostic value. RESULTS Age at the time of diagnosis, WHO classification and GS had no value as prognostic criteria, and only MNV correlated significantly with prognosis of Stage D2 prostate cancer (P = 0.0017). CONCLUSION Results of this study indicate that MNV is prognostically superior to morphologic grading of malignancy, such as GS and WHO classification, in Stage D2 prostate cancer.
Collapse
Affiliation(s)
- K Fujikawa
- Department of Urology, Shizuoka City Hospital, Japan
| | | | | | | |
Collapse
|