Artacho-Pérula E, Roldán-Villalobos R, Martínez-Cuevas J F, López-Rubio F
Department of Morphological Sciences (Section of Histology), School of Medicine, University of Córdoba, Spain.
J Pathol. 1994 Jun;173(2):105-14. doi: 10.1002/path.1711730206.
Specimens from 60 cases of renal cell carcinoma (RCC) were graded employing quantitative nuclear data combined with multivariate discriminant analysis. Evaluation of patient survival was analysed with respect to quantitative microscopic and qualitative features. Both morphometric and stereological estimators were used to establish the nuclear size and form pattern of the RCC specimens. Tumoural dedifferentiation paralleled progressive increases in nuclear elongation and in two- and, especially, three-dimensional--mean nuclear volume (MNV)--size parameters. Using stepwise discriminant analysis, 85.0 per cent of the specimens were correctly classified when differentiating grade 2 and 3 tumours. It is concluded that simple and realistic estimates of MNV are the best discriminator for objective grading in patients with RCC. Univariate survival analysis demonstrated the important significance of several features such as MNV, clinical stage, and nuclear discriminant and histopathological tumour grades. Nuclear form factor PE, area, and perimeter were also significant. A prognosis study based on the Cox model using a stepwise selection of parameters showed that only MNV has an independent prognostic role when examining all investigated quantitative parameters. The clinical stage was the best prognostic feature when all quantitative and qualitative characteristics were included in the analysis.
采用定量核数据结合多变量判别分析方法，对60例肾细胞癌（RCC）标本进行分级。从定量显微镜检查和定性特征方面分析患者的生存情况。形态测量和体视学估计器均用于确定RCC标本的核大小和形态模式。肿瘤去分化与核伸长以及二维尤其是三维平均核体积（MNV）大小参数的逐渐增加平行。使用逐步判别分析，在区分2级和3级肿瘤时，85.0%的标本被正确分类。得出结论，简单且实际的MNV估计是RCC患者客观分级的最佳判别指标。单变量生存分析表明，MNV、临床分期、核判别和组织病理学肿瘤分级等几个特征具有重要意义。核形态因子PE、面积和周长也具有显著性。基于Cox模型并采用逐步参数选择的预后研究表明，在检查所有研究的定量参数时，只有MNV具有独立的预后作用。当分析中纳入所有定量和定性特征时，临床分期是最佳的预后特征。
