Sørensen F B, Kristensen I B, Grymer F, Jakobsen A
Stereological Research Laboratory, University of Aarhus, Denmark.
Am J Dermatopathol. 1991 Feb;13(1):11-9. doi: 10.1097/00000372-199102000-00004.
The mutual relation and prognostic value of three quantitative variables were investigated in a retrospective series of 56 stage I cutaneous malignant melanomas. Unbiased stereological estimates of nuclear volume, nuclear nu v were obtained along with measurements of melanoma thickness. The DNA index (DI) was determined by flow cytometry in adjacent sections from the same paraffin-embedded specimens. The correlation between tumor thickness and nuclear nu v was only moderate (r = .60). Euploid lesions had a smaller nuclear nu v than aneuploid tumors (2p = .01), but with considerable overlap. No significant association between tumor thickness and DI could be demonstrated. Single-factor analysis showed prognostic value of nuclear nu v and tumor thickness (2p = .0007 and 2p = .03, respectively), whereas DI was without prognostic impact (2p = .54). When analyzing the three parameters in a Cox model, nuclear nu v was the only independent, prognostically significant variable. Physical, three-dimensional nuclear volume is not solely a reflection of nuclear DNA content, and may represent a valuable, quantitative prognostic indicator in cutaneous malignant melanomas.
在一项对56例I期皮肤恶性黑色素瘤的回顾性研究中，对三个定量变量的相互关系及预后价值进行了调查。获得了核体积、核仁组成区嗜银蛋白（AgNOR）的无偏体视学估计值，同时测量了黑色素瘤厚度。通过对同一石蜡包埋标本的相邻切片进行流式细胞术测定DNA指数（DI）。肿瘤厚度与核仁组成区嗜银蛋白之间的相关性仅为中等程度（r = 0.60）。整倍体病变的核仁组成区嗜银蛋白比非整倍体肿瘤小（P = 0.01），但有相当大的重叠。未发现肿瘤厚度与DNA指数之间有显著关联。单因素分析显示核仁组成区嗜银蛋白和肿瘤厚度具有预后价值（P分别为0.0007和0.03），而DNA指数无预后影响（P = 0.54）。在Cox模型中分析这三个参数时，核仁组成区嗜银蛋白是唯一独立的、具有显著预后意义的变量。实体的三维核体积并非仅仅是核DNA含量的反映，在皮肤恶性黑色素瘤中可能是一个有价值的定量预后指标。
