Lipponen P K
Department of Pathology, University of Kuopio, Finland.
Anticancer Res. 1993 Mar-Apr;13(2):529-32.
The prognostic value of stereologically estimated nuclear volume was compared to the prognostic value of clinical, histological, morphometric and flow cytometric prognostic factors in a cohort of 212 patients followed up for over 11 years. T-category (p = 0.014), grade (p < 0.0001), papillary status (p = 0.001), nuclear area (p < 0.0001), SD of nuclear area (p < 0.0001), DNA ploidy (p < 0.0001), S phase fraction (p < 0.0001), mitotic index (p < 0.0001) and nuclear volume were significantly interrelated. Progression in T- (p = 0.090), N- (p = 0.007) and M-categories (p = 0.001) was related to nuclear volume, while independent predictors of progression in a multivariate analysis were grade and S phase fraction. Nuclear volume predicted survival in the entire cohort (p = 0.0004) and in papillary tumours (p = 0.0048), whereas in superficial tumours it had no prognostic value. In multivariate survival analysis T-category (p < 0.001), papillary status (p < 0.001) and S phase fraction (p = 0.011) predicted survival and S phase fraction predicted (p = 0.052) recurrence-free survival in Ta-T1 tumours. The results suggest that stereological measurement of nuclear volume provides no additional prognostic information over proliferation indices (mitotic index, S phase fraction) in bladder cancer.
在一组212例随访超过11年的患者中，将体视学估计的核体积的预后价值与临床、组织学、形态学和流式细胞术预后因素的预后价值进行了比较。T分期（p = 0.014）、分级（p < 0.0001）、乳头状态（p = 0.001）、核面积（p < 0.0001）、核面积标准差（p < 0.0001）、DNA倍体（p < 0.0001）、S期分数（p < 0.0001）、有丝分裂指数（p < 0.0001）和核体积显著相关。T分期（p = 0.090）、N分期（p = 0.007）和M分期（p = 0.001）的进展与核体积有关，而多变量分析中进展的独立预测因素是分级和S期分数。核体积可预测整个队列（p = 0.0004）和乳头状肿瘤（p = 0.0048）的生存率，而在浅表肿瘤中它没有预后价值。在多变量生存分析中，T分期（p < 0.001）、乳头状态（p < 0.001）和S期分数（p = 0.011）可预测生存率，S期分数可预测Ta-T1肿瘤的无复发生存率（p = 0.052）。结果表明，在膀胱癌中，核体积的体视学测量相对于增殖指数（有丝分裂指数、S期分数）没有提供额外的预后信息。
