COMPUTER-ASSISTED IMAGE-ANALYSIS OF TUMOR SECTIONS FOR A NEW THROMBOSPONDIN RECEPTOR

BACKGROUND: A cell surface receptor (50 kd) has been recently identifi ed in malignant cells that recognizes the tumor cell adhesive domain t ie, cysteine-serine-valine-threonine-cysteine-glycine [CSVTCG]) of thr ombospondin (TSP). This CSVTCG-specific TSP receptor can be considered as a new tumor marker, and its concentration on the cell surface may correlate directly with the capacity of tumor cells to invade and meta stasize. MATERIALS AND METHODS: Six patients with primary, stages III and ni squamous cell carcinomas of the head and neck were studied. Tum or sections were specifically stained for this receptor with immunohis tochemical techniques. The stained specimens were then subjected to co mputer-assisted image analysis. The area of positive staining and the heterogeneity of the pattern of Staining were compared to peritumoral angiogenesis and clinical outcome of tbe patients. RESULTS: The result s indicate that those patients with a high and homogenous positive sta in score (mean +/- standard error [SE] 78 +/- 5%) for the CSVTCG-speci fic TSP receptor had high microvessel density and died from metastatic disease within 12 months Of initial treatment (correlation coefficien ts = 0.95 and 1, respectively). Patients with a low and heterogenous p ositive stain score for receptor (mean +/- SE 8 +/- 2%; P <0.001) had low microvessel counts and remained disease-free for at least 2 years. There was no relationship between receptor density and histologic cla ssification of the primary tumors. CONCLUSION: The CSVTCG-specific TSP receptor, quantified through image analysis of immunohistochemical st ained tissue sections, is highly predictive of clinical outcome in pat ients with squamous cell carcinomas of the head and neck.