Prognostic significance of nuclear morphometry in superficial bladder cancer

OBJECTIVE: To evaluate the significance of nuclear morphometry in predictin g the clinical course in superficial (pTa and pT1) bladder cancer. STUDY DESIGN: The study included 73 patients with superficial transitional cell carcinoma of the bladder who were followed for a median of 21 months ( range, 1-90). Nuclear morphometry was performed by a computer-assisted imag e analyzer system on hematoxylineosin-stained histologic sections and chara cterized by five nuclear variables: area, perimeter, major and minor diamet er, and form factor. Patient charts and microscopic slides were reviewed to record tumor stage, grade and size. Tumor proliferative activity was asses sed by immunohistochemical staining with Ki-67 antibody, RESULTS: None of the morphometric variables showed a significant relation t o tumor progression and recurrence. Higher values of mean nuclear area, per imeter, and major and minor diameter were significantly related to higher g rade and proliferative activity. Mean nuclear area and minor diameter were associated with advanced stage. Of established prognostic factors, only his tologic grade was significant in predicting progression. CONCLUSION: The results suggest that nuclear morphometry may be valuable in determining proliferative activity and may be well correlated with histolo gic grade in superficial bladder cancer. However, like many other potential prognostic factors, it seems to be unreliable in predicting clinical behav ior.