COMBINED ANALYSIS OF FLOW-CYTOMETRY AND MORPHOMETRY OF OVARIAN GRANULOSA-CELL TUMOR

Background. It is difficult to determine the prognosis of granulosa ce ll tumors (GCT) at the time of diagnosis. Methods. The nuclear DNA con tent of 17 patients with ovarian GCT was investigated by flow cytometr y using paraffin-embedded tissue. Nuclear area (NA), nuclear perimeter (NP), and nuclear shape factor (NSF) were measured by an image analyz er using hematoxylin- and -eosin-stained sections. Results. The follow -up period of the patients ranged from 2 months to 11 years. Thirteen tumors were diploid or near diploid, whereas one was tetraploid, and t hree were aneuploid. Two tumors had varying degrees of DNA content het erogeneity. Crude survival of the patients with an euploid tumor (13 d iploid, 1 tetraploid) was more favorable than that of the patients wit h an aneuploid tumor. Patients with S-phase fraction (SPF) greater tha n 10% or DNA content heterogeneity experienced disease recurrence or m etastasis. A significant difference was observed in NA and NP between those with and without metastasis. Conclusions. Our results indicate t hat DNA aneuploidy, large SPF, DNA content heterogeneity, and large NA and NP are adverse prognostic factors in GCT. Thus, flow cytometric a nd morphometric measurement may provide a rapid and valuable method to predict the biologic behavior of GCT.