Nuclear profiles of cancer cells reveal the metastatic potential of gastric cancer

Nuclear profiles have been reported as useful prognostic predictors in vari ous cancers. Data from computerized morphometry are objective and can be qu ickly derived using conventional microscopic analysis, but image analysis o f nuclear features has only rarely been applied to investigations of gastri c cancer. The aim of this study was to evaluate the correlation between one of these morphological nuclear features and the clinicopathological parame ters in patients with gastric cancer. The morphometric nuclear feature (nuc lear area) was analysed in 400 patients with gastric cancer. In each case, 300 cancer nuclei on routine haematoxylin and eosin-stained slides were ana lysed through the use of a computer-assisted image analysis system which tr aced the nuclear profiles (magnification x 400) on a computer monitor. The morphometric data were compared with the patients' clinicopathological stat us and survival rate. The mean nuclear area (NA) of cancer cells from 400 c ases of gastric cancer was 47.2 mu m(2). The NAs of cancer cells from tumou rs with microvessel invasion (lymphatic or venous invasion), lymph node met astasis or hepatic metastasis at the time of operation were significantly l arger than those of cancer cells from tumours without such invasion or meta stases. Cytokeratin (CK) immunostaining was performed on 2577 lymph nodes f rom 91 patients with advanced gastric cancer (pT3, pN0, pM0, stage II) to d etect micrometastases. CK-positive lymph nodes were detected in 350 of 2577 lymph nodes (13.6%) and in 62 of 91 patients (68.1%). The mean NA of cance r cells from 62 tumours with micrometastases (44 mu m(2)) was larger than t hat of cancer cells from 29 tumours without micrometastases (38.8 mu m(2), p = 0.043), and a significant positive correlation was detected between the NAs of cancer cells from 91 tumours and the number of micrometastatic lymp h nodes of 91 patients (rho=0.278, p=0.008). Cancer cells with large NA cor related strongly with haematogenous and lymph node recurrence or relapse af ter gastrectomy and the NA of cancer cells was identified as an independent prognostic factor in gastric cancer. Nuclear morphometry is an objective, reproducible, and technically uncomplicated procedure. The NA of cancer cel ls correlates closely with the metastatic potential of gastric cancer. Nucl ear morphometry may therefore be useful for the selection of patients who a re at risk of haematogenous or lymph node metastatic recurrence after surge ry. Copyright (C) 2000 John Wiley & Sons, Ltd.