THE EFFECT OF FIXATION ON THE SIZE, SHAPE AND SUMMED OPTICAL-DENSITY OF ENDOMETRIAL CANCER NUCLEI

Objective: Nuclear morphometric features have been shown to be of prog nostic importance in several malignancies including recently, endometr ial cancer The authors attempted to see whether the type of fixation a ffected nuclear size (NUSZ), shape (NUSH), and summed optical density (NUSD). Methods: Fifty specimens, half air dried and half alcohol fixe d, were obtained from 25 consecutive patients with endometrial cancer. Results were compared with the paired samples t-test. Differences amo ng the nuclear morphometric features and histologic grade, stage, and depth of myometrial invasion were studied by one-way analysis of varia nce. Logistic regression was used to determine if any were independent prognostic features. Image analysis was used to determine NUSZ, NUSH, and NUSD. Results: Mean NUSZ was shown to be significantly larger in air dried specimens (89.13 mu m(2)) as compared to alcohol fixed speci mens (80.34 mu m(2)) P=0.047. Mean NUSH was significantly closer to ro und in air dried specimens (15.21) as compared to alcohol fixed specim ens (15.65) P=0.025. There was no significant difference in mean NUSD between air dried (128.61) and alcohol fixed specimens (126.22) P=0.76 . Stage, as well as air dried NUSZ, NUSH, and NUSD were all independen t predictors of recurrence. In this study none of the nuclear paramete rs from the alcohol fixed tissues were predictive of recurrence. Concl usion: The type of fixation significantly affects the nuclear morphome tric parameters of size and shape. While NUSZ, NUSH, and NUSD from air dried specimens were predictive of recurrence, the same parameters fr om alcohol fixed specimens were not. A larger prospective trial is cur rently underway to validate these findings.