The use of nuclear morphometry for the prediction of survival in patients with advanced cancer of the larynx.

We examined retrospectively whether the quantitative morphometric analysis of nuclear shapes in patients with advanced cancer of the larynx could be used as a prognostic factor. In all, specimens were taken from 90 patients treated by surgery in the Department of Otolaryngology, Jagiellonian University, Cracow, Poland, between 1987 and 1988. The follow-up period was no shorter than 5 years. In the group examined there were 59 patients with T3 tumors and 31 with T4 tumors. A neck dissection was performed on one or both sides in each case. Metastases in regional lymph nodes were found in 26 patients. Histologic grading was assessed in all cases. Fourteen parameters of nuclear shape were studied using a computer-assisted system of image analysis. Morphometric data were compared with patients' survival rates. The worse survival rates were found to be linked with a nuclear area (NA) > or = 64.82 micron 2 and its standard deviation (SDNA) > or = 20.10 micron 2, a nuclear perimeter (NP) > or = 32.45 microns and its variation (SDNP) > or = 4.77 microns, nuclear density (ND) > or = 22,215.63 and its variation (SDND) > or = 6930.85 and nuclear roundness (NR) > or = 0.76. By using multivariate Cox regression analysis the SDND, presence of metastases in lymph nodes and low tumor differentiation were found to be independent prognostic factors. No statistically significant correlation was found between the parameters examined, lymph node status and tumor differentiation.