INTRATUMOR HETEROGENEITY OF MORPHOMETRIC AND STEREOLOGIC VARIABLES INPRIMARY OVARIAN-TUMORS AND THEIR OMENTAL METASTATIC DEPOSITS

OBJECTIVE: To compare quantitative pathologic variables assessed in pr imary ovarian tumors and metastatic tumor deposits in the omentum and compare their prognostic value. STUDY DESIGN: In 29 cases of advanced ovarian cancer the mean nuclear area (MNA), volume-weighted mean nucle ar volume ((v) over bar)(v), volume percentage epithelium (VPE) and mi totic activity index (MAI) were assessed in both the primary ovarian t umor and its metastatic deposits in the omentum. Differences were eval uated using the Wilcoxon rank sum test for paired observations, and co efficients of variation were calculated in each case over the values o btained from the tumor in the ovary and omentum. RESULTS: Intraobserve r and interobserver reproducibility of MNA, VPE and MAI were all good to very good except for the interobserver reproducibility for (v) over bar(v) which was moderate. MNA and (v) over bar(v), correlated well, both in the primary ovarian tumor (r=.88) and omental metastasis (r=.8 7). No significant differences were found between the assessments of M NA, (v) over bar(v), and MAI in the primary ovarian tumor and its omen tal metastasis, whereas significant differences were found for VPE. Ho wever, in some patients the nuclei tended to be larger and the VPE low er in the omental metastasis than irt the primary ovarian tun?or. No i mportant impact of the origin of tumor tissue was reflected in the pro gnostic value of the nuclear features. Patients were grouped prognosti cally differently for the assessment of MAI and VPE in the primary ova rian tumor and its omental metastasis. CONCLUSION: Quantitative pathol ogic variables for prognostic purposes are best assessed in the primar y ovarian tumor. Measurements in the metastatic deposits may be helpfu l in understanding processes of metastasis in advanced ovarian cancer.