KARYOMETRIC ANALYSIS OF INTRA-TUMOR HETEROGENEITY IN PROSTATE ADENOCARCINOMA

The intra-tumour heterogeneity in different locations in the prostate was determined by karyometric image analysis and compared with local t umour progression in a retrospective analysis of 65 patients with loca lized adenocarcinoma of the prostate. In these 65 radical prostatectom y specimens 290 tumour locations were documented. In each location tum our volume was estimated and Gleason grade determined [12]. Quantitati ve image analysis of nuclear size, shape and chromatin pattern was per formed. Differences in Gleason grade and karyometric feature values we re evaluated as measures for intra-tumour heterogeneity. Moreover, the location within the prostate was documented for each tumour area. Gle ason grade and karyometric features varied widely in the prostate. Tum our locations in the apex (n = 92) had significantly larger and more i rregularly shaped nuclei (P < 0.005) compared with basally located tum ours (n = 49). Significant differences in nuclear shape were also foun d in different locations in the equatorial plane of the organ. Tumour heterogeneity in chromatin pattern features was found to correlate wit h local extension (seminal vesical invasion, extracapsular tumour grow th, positive resection margins) and lymph node metastases. This correl ation was even stronger when more pathological features were present. In view of the observed tumour heterogeneity, (karyometric) analysis o f multiple tumour areas in the prostate is advisable for optimal evalu ation of prostate carcinoma.