THE PROGNOSTIC-SIGNIFICANCE OF HISTOMORPHOMETRY AND IMMUNOHISTOCHEMISTRY IN GIANT-CELL TUMORS OF BONE

Eighty-two cases of giant cell tumor (GCT) were reviewed. Hematoxylin- eosin- and hematoxylin, phloxine, saffron, and alcian green-stained se ctions (82 cases) were examined for mitotic rate, the number of giant cells, and the pleomorphism of the stromal cells. In 29 cases, the tum or was stained for CD68, alpha(1)-antichymotrypsin (AlACT), S100 prote in, Muramidase, and von Willebrand factor (factor vm). The staining pr operties of mononuclear and multinucleated giant cells were compared. Morphometric analysis was performed on 14 cases with a LECO 2001 compu ter-assisted image analyzer (LECO Instruments Ltd, Mississauga, Ontari o, Canada) and included absolute cell count, nuclear area, perimeter, roughness, roundness, and aspect and nuclear versus cytoplasmic ratios , measured both in the stromal cells and giant cells. The Eases were d ivided into four groups: (I) cases with metastasis, (2) cases with rec urrence, (3) cases with both metastasis and recurrence, and (4) cases with neither metastasis nor recurrence. Immunohistochemistry revealed a stronger AlACT than muramidase positivity in general. The staining w as stronger in stromal cells than in giant cells. Giant cells in all t umors were positive for CD68. Stromal cells showed weaker positivity f or the same stain. The number of asymmetrical mitotic figures was sign ificantly greater in group 3 than in group 4 (P <.05). Morphometric as sessment has identified a statistically significant difference in the aspect ratio and the roundness of the nuclei between these two groups. The other parameters did not differ significantly. In this article, t he significance of these findings in prognostication and the histogene sis of the giant cell tumor are discussed. Their clinical applicabilit y is yet to be determined. Copyright (C) 1996 by W.B. Saunders Company .