Mean Of Nuclear Area Research Articles

Role of quantitative nuclear cytomorphometric and NOR dots count in prediction of carcinogenic induced oral cellular proliferative activity

Introduction: To find a better way for predicting the cellular proliferative activity of apparently healthy oral epithelium exposed to certain carcinogens. Methods: The nuclear area (NA) and nucleolar organizer regions (NORs) counts were compared with that of cytological atypia in 100 cases of epithelia exposed to toombak (carcinogen), 100 controls (non­exposed) and two cases of squamous cell carcinoma (SCC), as internal controls. Results: Significant differences in AgNOR (p<0.001) mean count and NA mean values (P<0.001) were identified between cases and controls. Significant differences were also noted in AgNOR mean count and NA mean values between cases and two cases of SCC. Conclusions: AgNOR mean count and NA are useful markers for prediction of cytologically non­evident proliferative activity of oral mucosa exposed to carcinogens.

The value of histoquantitative measurements in prognostic assessment of renal adenocarcinoma.

In a series of 135 patients with renal-cell carcinomas (followed up for a mean of 9.5 years), a variety of clinical and histological factors were analyzed in relation to morphometric measurements of the nuclear parameters in the primary tumours to establish their value as prognostic factors. Clinical, histological and morphometric factors were significantly interrelated in that the metastatic high-grade tumours had larger nuclei, larger variation in nuclear size and shape, and were also rapidly proliferating. In a univariate analysis, the most important clinical predictor of recurrence-free survival (RFS) was T category, followed by combined nuclear grade, N category, nuclear grade, tumour size, sex and M category. The most important quantitative predictor of RFS was the mean area of the 10 largest nuclei (NA10), the mean of the longest nuclear axis (Dmax), SD of nuclear area (SDNA), the volume-corrected mitotic index (M/V index), inflammatory-cell reaction, SD of nuclear perimetry (SDPE), and the mean of nuclear area (NA). M category, T category, combined nuclear grade, nuclear grade and N category were significantly related to patient survival. Of the quantitative variables, M/V index, Dmax and NA were significant predictors of survival in a univariate analysis. Females had longer RFS than men, and density of tumour-infiltrating lymphocytes (TIL) referred to an increased risk of recurrent tumour in both sexes. In a multivariate analysis, the RFS was independently predicted by the clinical stage, female sex and mitotic frequency/mm2, while nuclear parameters or nuclear grading had no independent prognostic value. The extent of the primary tumour was the single most important determinant of survival, followed by the proliferation rate of the tumour. In local T1-2NOMO tumours, mitotic frequency/mm2 was the only independent prognostic factor for RFS. The clinical stage, mitotic frequency/mm2, nuclear grade and density of TIL were independent predictors in Cox's analysis. In these local tumours, mitotic frequency/mm2 of neoplastic epithelium was the only independent prognostic factor. The results indicate that although an accurate prognostic evaluation of renal-cell carcinomas can be based on subjective nuclear grading and histoquantitative measurements of nuclear parameters, the simple assessment of mitotic frequency alone supplies most of the prognostic data, particularly in local tumours.

The prognostic value of morphometrical features and cellular DNA content in cis-platin treated late ovarian cancer patients.

In 73 CAP-1 treated stage III and IV ovarian cancers, the prognostic significance of morphometric features and cellular DNA content has been evaluated in comparison with histologic type, grade of differentiation and a number of clinical characteristics. Borderline tumours were excluded from the study. Median follow-up was 44 months, median survival time 36 months. Single features associated with prognosis were (in order of decreasing significance according to single variate analysis): FIGO stage (P = 0.0002), bulky disease (P = 0.004), standard deviation and mean of nuclear area (P = 0.0006 and P = 0.01), cellular DNA content (P = 0.01), mitotic activity index (P = 0.08) and volume percentage epithelium (P = 0.13, not quite significant). Tumours with a mean nuclear area greater than 70 micron2 (which occurred in 35% of the cases) were nearly all aneuploid. Multivariate analysis showed that the statistically most significant prognostic combination of features consisted of mean nuclear area, presence or absence of bulky disease and FIGO stage (in order of decreasing importance) (Mantel-Cox = 23.07, P less than 0.00001). A low value for the multivariate function of this combination of features was associated with a poor prognosis within 24 months, a high value with a favourable outcome. Another favourable combination of features appeared to be diploid cellular DNA content and a low mitotic activity index (11 patients, one died). However, even with the prognostically most favourable combination of these features, several patients died. Of all combinations of features investigated, only two were associated with an excellent prognosis (low mitotic activity index and low volume percentage epithelium). Cancers of 7 patients (10%) displayed such features, and none of them died during the follow-up period (minimally 20 and maximally 54 months). It is concluded that morphometric and flow cytometric analysis can provide significant and objective information to predict the prognosis of cis-platin-treated advanced ovarian cancer patients.