PROGNOSTIC EVALUATION OF MORPHONUCLEAR PARAMETERS IN SUPERFICIAL AND INVASIVE BLADDER-CANCER

Objective To assess the prognostic value of morphonuclear parameters d etermined by means of computerized image analysis in untreated bladder tumours. Patients and methods Fifty patients had untreated bladder ca ncer; in 28 patients the tumours were superficial (7pT1G1: 14pT1G2: 7p T1G3) and in 22 they were invasive (6T2G2, 9T2G3, 2T3G2, 5T3G3), Feulg en-stained imprints were processed for morphonuclear analysis on a SAM BA 200 computerized image analysis system (T1TN, France), which measur es optical density (integrated optical density, IOD; surface area, SUR F; mean optical density, MOD), texture (long run length, LRL; short ru n length, SRL: run length distribution, RLD; run length percentage, RL P; grey level distribution, GLD) and contrast (contrast, C; energy, E) . Results Morphonuclear parameters IOD, SURF, LRL, SRL and C were foun d to correlate with the risk of recurrence and progression of superfic ial bladder tumours (results for ANOVA respectively IOD P < 0.001: SUR F P = 0.02; LRL P = 0.05: RLD P = 0.04, SRL P = 0.04: C P < 0.0011. In invasive bladder cancer, parameters IOD and C only correlated with th e risk of progression (ANOVA respectively IOD P < 0.001: C P < 0.001), On the other hand, progression-free curve analysis using the Kaplan M eier method showed that morphonuclear parameters may be useful in pred icting the outcome for superficial tumours (Log/Rank test: SURF P < 0. 001: RLD < 0.001; SRL = 0.003; LRL < 0.001: C < 0.001; IOD < 0.001), I n the case of invasive rumours, only two parameters provided prognosti c information (Logrank test: C < 0.001: IOD < 0.001). Conclusion Nucle ar morphometry assessed by image analysis is potentially useful in ass essing the prognosis of bladder rumours; it provides objective and qua ntitative parameters. Further studies will determine whether morphonuc lear analysis can be used to monitor the treatment of bladder cancer, particularly superficial tumours.