Prognostic value of nuclear area index in patients with bladder cancer

Abstract

Background : To assess the prognostic usefulness of the nuclear area index (NAI), a new nuclear morphometric parameter expressed as the mean nuclear area (MNA) ratio of cancer to normal transitional cells in patients with bladder cancer, who have undergone radical cystectomy. Methods : Measurements of the nuclear areas of cancer and normal transitional cells were carried out on the histological slides of 73 patients with bladder cancer. The clinical usefulness of MNA, NAI, grade, and TNM categories for the prediction of the cause-specific survival of the patients was examined.Results : The median values of MNA and NAI in the 73 patients were 39 m m 2 and 1.2, respectively. Cause-specific survival rates of the patients were calculated according to stage (T1-2 vs T3-4), grade (grade 2 vs grade 3), MNA ( < 39 m m 2 vs ≥ 39 m m 2 ) and NAI value ( < 1.2 vs ≥ 1.2). Using univariate analysis, all these parameters were statistically significant prognostic factors. However, by multivariate analysis, NAI was the only independent variable for the survival of the patients ( P < 0.01). Causespecific survival rates of patients with NAI values of less than 1.2 were significantly higher than those with NAI values of 1.2 or more, in both grade 2 and grade 3 tumors. Conclusions : These results suggest that NAI could provide improved prognostic information for patients with bladder cancer.

DNA ploidy, nuclear size, proliferation index and DNA-hypomethylation in ovarian cancer

“…One of the most important reports advocating the introduction of DNA ploidy as a prognostic discriminator for patient recruitment in phase III treatment studies, was that of Kimming et al, who revealed DNA ploidy to be as powerful as or even more powerful than residual disease after primary surgery in multivariate analysis for predicting clinical outcome in advanced ovarian cancer [13]. Prognostic value of proliferative activity and nuclear morphometry in terms of the nuclear area has also been shown in patients with bladder cancer [14,15]. …”