Value of morphometric nuclear image analysis using the Feulgen reaction inrenal cell carcinoma

OBJECTIVE. To evaluate retrospectively the ability of morphometric nuclear image analysis to predict survival in patients with renal cell carcinoma. STUDY DESIGN: The subjects were 40 patients with previously untreated venal cell carcinoma. Pathologic stage was determined using Robson's stage syste m. Nuclear grade was assigned according to the criteria of Fuhrman et al, W e used the Feulgen staining technique, which has been widely used for the h istochemical assessment of nuclear DNA content. A minimum of 300 nuclei wer e analyzed from each subject. Five variables in morphometric nuclear image analysis were measured: nuclear area, nuclear perimeter, nuclear ellipticit y, nuclear regularity and DNA content. Cox's proportional hazard model was applied to identify prognostic usefulness with respect to survival time. RESULTS: All nuclear morphometric variables but nuclear regularity correlat ed with tumor grade. According to univariate survival analyses, Robson stag e and nuclear ellipticity revealed a prognosis on survival with statistical significance. After adjustments for age and sex, nuclear ellipticity remai ned the only significant prognostic factor related to survival (P<.01). The survival rates were relatively high for patients with nuclear ellipticity >773 as compared to those with nuclear ellipticity <773 (P<.05). CONCLUSION: These findings indicate that morphometric nuclear image analysi s using the Feulgen reaction is a reliable and efficient technique and that nuclear ellipticity is the most discriminating morphometric variable for p redicting the prognosis of renal cell carcinoma patients.