IDENTIFICATION OF A LOW-RISK GROUP OF STAGE-I BREAST-CANCER PATIENTS BY CYTOMETRICALLY ASSESSED DNA AND NUCLEAR TEXTURE PARAMETERS

Image cytometrical measurements were performed on Feulgen-stained cell s from 329 stage I breast cancers (pTlpNO,MO,RO). For each patient, se veral DNA (ploidy, S-phase fraction, exceeding rates, 2c deviation ind ex, ploidy balance, entropy, and histogram typing), morphometric (area and radius of nuclei), and textural parameters (mainly co-occurrence and run-length) were calculated. The prognostic value of these paramet ers was investigated by multivariate Cox regression analysis, consider ing a distant recurrence-free survival of 8 years as the prognostic cr iterion. In the multivariate analysis, one DNA parameter (histogram ty pe) and two textural parameters (co-occurrence and variation of the av erage heterochromatin area) were proven to have independent prognostic value. Using a linear combination of these variables, a prognostic fa ctor was calculated for each individual patient. Patients were stratif ied using this factor into several groups according to their risk for distant recurrence. Thus, a low-risk group of stage I patients was ide ntified, remaining distant recurrence-free for 8 years. In addition, a group of patients with a worse prognosis and an 8-year recurrence rat e of about 26 per cent was identified, compared with the average dista nt recurrence rate of all stage I patients of 13 per cent. A combinati on of DNA and textural parameters can provide powerful prognostic info rmation in stage I breast carcinomas and may allow a better selection of patients for different therapy protocols.