QUANTITATIVE IMAGE CYTOMETRY OF INFILTRATING DUCTAL CARCINOMA - COMPARISON WITH PROGNOSTIC PARAMETERS AND REPRODUCIBILITY OF HISTOLOGICAL GRADE

Quantitative image cytometry was used to compare 18 parameters relatin g to ploidy, nuclear area, and chromatin texture to axillary lymph nod e status, tumor size, and histological grade for 34 infiltrating ducta l carcinomas, each of which had been graded independently by each of s ix surgical pathologists. Zinc formalin-fixed, paraffin-embedded tumor s were assessed using the Elston and Ellis modification of the Bloom a nd Richardson histological grading scheme. When axillary lymph node-ne gative tumors were compared with those involving four or more nodes, % 2c (diploid) cells, nuclear area, and eight of 12 chromatin texture p arameters showed statistically significant differences. Carcinomas <2 cm had more % 2c (diploid) cells and fewer % >4 c (hypertetraploid) ce lls than larger neoplasms. For tumors having nuclear pleomorphism scor e two versus those with score three, nuclear area, four of five parame ters related to ploidy level, each of five parameters related to run-l ength matrix features and one of four co-occurrence matrix features sh owed significant differences. Nearly all of these cytometric parameter s also showed significant differences for histological grade and mitot ic count, which was strongly correlated with nuclear pleomorphism. In examining the cytometric parameters in relation to the interobserver r eproducibility of histological grade and its components, the largest n umber of statistically significant parameters related to the nonreprod ucibility of nuclear pleomorphism. The findings indicate that as the g rade of infiltrating ductal carcinomas increases, there are fewer % 2 c (diploid) cells and more % >4 c (hypertetraploid) and % greater than or equal to 5 c (polyploid) cells. In addition, the cells of high gra de tumors have larger nuclear areas and more small and large dense chr omatin clumps, which increase in such number that they tend to join to gether. When compared with the cytometric parameters, nuclear pleomorp hism is the most sensitive component of grade to nonreproducibility. C opyright (C) 1996 by W.B. Saunders Company.