Vogt T, Stolz W, Hohenleutner U, Schiffner R, Landthaler M
Department of Dermatology, University of Regensburg, Germany.
Recent Results Cancer Res. 1995;139:195-204. doi: 10.1007/978-3-642-78771-3_14.
In the present study we evaluated the prognostic impact of both DNA cytometry and quantitative histology in patients with malignant melanoma (MM). In contrast to previous investigations on sections, rapid image analysis (IA) of imprint specimens was performed to measure DNA cytometric features; 34 cases of stage I MM with low (< 1.5 mm, n = 20) and higher tumor thickness (TTH) (> 1.5 mm, n = 14) were analyzed. We found significant correlations between cytometric features and TTH, which is accepted as the most important prognostic criterion in MM. Higher TTH was closely correlated with the rate of markedly aneuploid nuclei, which is indicated by the 5c exceeding rate (5cER; r, 0.89; p < 0.001). The gain of chromatin in thicker tumors was accompanied by higher mean nuclear area (MAREA; r, 0.60; p < 0.001) and mean DNA content (MDNA; r, 0.58; p < 0.001). Additional evidence for prognostic significance of cytometry was obtained by preliminary survival analysis of 16 cases (four patients died within 2 1/2 years and 12 patients survived for at least 4 1/2 years). Applying multivariate stepwise discriminant analysis, a combination of TTH, level of invasion (LEV), 2c deviation index (2cDI), and modified standard deviation of the DNA values (SDNAM) proved to be most effective. One hundred percent of the cases were correctly classified as survivors or nonsurvivors. TTH and the 5cER were found to be the best univariate criteria for prognosis. In the U test according to Mann and Whitney, a significant discrimination of survivors and nonsurvivors was possible using either TTH or the 5cER, respectively (p < 0.02). Thus, we would like to conclude that IA of imprint specimens can be recommended as a rapid and simple additional method for grading.
在本研究中，我们评估了DNA细胞计数法和定量组织学对恶性黑色素瘤（MM）患者的预后影响。与之前对切片的研究不同，我们对印片标本进行快速图像分析（IA）以测量DNA细胞计数特征；分析了34例I期MM患者，其中肿瘤厚度较低（<1.5 mm，n = 20）和较高（>1.5 mm，n = 14）。我们发现细胞计数特征与肿瘤厚度（TTH）之间存在显著相关性，而肿瘤厚度被认为是MM中最重要的预后标准。较高的TTH与明显非整倍体核的比例密切相关，这通过5c超过率（5cER；r，0.89；p < 0.001）来表示。较厚肿瘤中染色质的增加伴随着更高的平均核面积（MAREA；r，0.60；p < 0.001）和平均DNA含量（MDNA；r，0.58；p < 0.001）。通过对16例患者的初步生存分析（4例患者在2.5年内死亡，12例患者存活至少4.5年），获得了细胞计数法具有预后意义的额外证据。应用多变量逐步判别分析，肿瘤厚度（TTH）、浸润水平（LEV）、2c偏差指数（2cDI）和DNA值的修正标准差（SDNAM）的组合被证明是最有效的。100%的病例被正确分类为存活者或非存活者。TTH和5cER被发现是最好的单变量预后标准。在根据Mann和Whitney进行的U检验中，分别使用TTH或5cER可以对存活者和非存活者进行显著区分（p < 0.02）。因此，我们得出结论，印片标本的IA可作为一种快速简便的额外分级方法推荐使用。
