NUCLEAR QUANTITATIVE GRADING BY DISCRIMINANT-ANALYSIS OF RENAL-CELL CARCINOMA SAMPLES - A PATIENT SURVIVAL EVALUATION

Specimens from 60 cases of renal cell carcinoma (RCC) were graded empl oying quantitative nuclear data combined with multivariate discriminan t analysis. Evaluation of patient survival was analysed with respect t o quantitative microscopic and qualitative features. Both morphometric and stereological estimators were used to establish the nuclear size and form pattern of the RCC specimens. Tumoural dedifferentiation para lleled progressive increases in nuclear elongation and in two- and, es pecially, three-dimensional-mean nuclear volume (MNV)-size parameters. Using stepwise discriminant analysis, 85.0 per cent of the specimens were correctly classified when differentiating grade 2 and 3 tumours. It is concluded that simple and realistic estimates of MNV are the bes t discriminator for objective grading in patients with RCC. Univariate survival analysis demonstrated the important significance of several features such as MNV, clinical stage, and nuclear discriminant and his topathological tumour grades. Nuclear form factor PE, area, and perime ter were also significant. A prognosis study based on the Cox model us ing a stepwise selection of parameters showed that only MNV has an ind ependent prognostic role when examining all investigated quantitative parameters. The clinical stage was the best prognostic feature when al l quantitative and qualitative characteristics were included in the an alysis.