Ladekarl M, Bæk-Hansen T, Henrik-Nielsen R, Mouritzen C, Henriques U, Sørensen F B
Stereological Research Laboratory, University of Aarhus, Denmark.
Cancer. 1995 Sep 1;76(5):797-802. doi: 10.1002/1097-0142(19950901)76:5<797::aid-cncr2820760513>3.0.co;2-m.
The prognostic value of quantitative histopathologic parameters was evaluated in 55 consecutively treated patients with operable lung carcinoma of squamous (N = 39) and mixed, adenosquamous (N = 16) cell type. Patients alive were followed for at least 12 years.
Using a projection microscope and a simple test system in fields of vision systematically selected from the whole tumor area of one routine section, five quantitative histopathologic variables were estimated: the mean nuclear volume, the mean nuclear profile area, the density of nuclear profiles, the volume fraction of nuclei to tissue, and the number of mitotic profiles per 10(3) nuclear profiles. For each patient, information was recorded regarding sex, age at diagnosis, and clinical stage of disease.
Single-factor analyses showed that a favorable prognosis was associated with early clinical stages (Stages I and II) and young age (P < or = 0.03), and that females tended to do better than males (P = 0.09). Estimates of the mean nuclear volume were of prognostic significance (P = 0.02), small nuclei being associated with the worst prognosis. In a multivariate Cox analysis, clinical stage, age, and mean nuclear volume were found to be parameters of significant, independent prognostic value.
The present feasibility study indicates that estimates of the mean nuclear volume are of prognostic value, independent of the clinical stage of disease. This quantitative histopathologic variable is highly reproducible and easily obtained using an unbiased stereologic method. Thus, the mean nuclear volume may be a parameter of future importance in the clinical management of patients with carcinoma of the lung.
对55例连续接受治疗的可手术切除的鳞状细胞型（N = 39）和混合性腺鳞癌（N = 16）肺癌患者，评估定量组织病理学参数的预后价值。对存活患者随访至少12年。
使用投影显微镜和一个简单的测试系统，在从一张常规切片的整个肿瘤区域系统选取的视野中，估计五个定量组织病理学变量：平均核体积、平均核轮廓面积、核轮廓密度、核体积与组织体积之比以及每10³个核轮廓中的有丝分裂轮廓数。记录每位患者的性别、诊断时年龄和疾病临床分期信息。
单因素分析显示，良好预后与早期临床分期（I期和II期）及年轻相关（P≤0.03），女性预后往往优于男性（P = 0.09）。平均核体积估计具有预后意义（P = 0.02），小核与最差预后相关。在多变量Cox分析中，发现临床分期、年龄和平均核体积是具有显著独立预后价值的参数。
本可行性研究表明，平均核体积估计具有预后价值，与疾病临床分期无关。这种定量组织病理学变量具有高度可重复性，使用无偏倚的立体学方法易于获得。因此，平均核体积可能是未来肺癌患者临床管理中一个重要的参数。
