Improved prediction of metastasis in tongue carcinomas, combining vascularand nuclear tumor parameters

BACKGROUND. Predicting the presence of metastasis, based on tumor or tumor- related characteristics is of utmost importance. The authors studied the si gnificance of tumor DNA features and tumor-related angiogenesis to predict the occurrence of metastasis in squamous cell carcinomas (SCCs) of the tong ue. METHODS. Paraplast blocks from resection specimens of 20 metastasized and 2 0 nonmetastasized SCCs of the tongue with a minimum follow-up of 24 months were used. Tissue sections were stained with anti-CD34 monoclonal antibodie s for vessel visualization, and according to Feulgen to stain DNA. Using im age analysis, data from both stainings were computed for each of the 40 car cinomas. A logistic regression model to predict the presence of metastasis, based on vascular and nuclear morphology features, was developed. RESULTS. The intratumor variation of chromatin condensation and the percent age vessels smaller than 5 mum in diameter were selected for the model. The model correctly predicted metastasis in 90% of patients and excluded metas tasis correctly in 75% of nonmetastasized tumors. Taking into account the p revalence of metastasis in SCC of the tongue of between 30% and 60%, this m eans a predictive value for a negative outcome of between 95% and 83%. CONCLUSIONS. The proposed model shows an improvement of predictive values c ompared with previous models with single parameters. Therefore, a multipara meter model appears to predict the multiparameter process of metastasis bet ter. (C) 2001 American Cancer Society.