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Nuclear morphometry for the prediction of regional lymph nodes metastases in patients with cancer of the larynx

ABSTRACT The changes in cell nuclei reflect their activity. Quantitative morphometric analyses of tumor nuclei could be instrumental in providing prognostic information. We studied whether, and if so, which specific nuclear parameters and histoclinical factors in patients with cancer of the larynx could be related to the lymph node metastases. Specimens were taken from 61 patients surgically treated in the Department of Otolaryngology, Jagiellonian University, Cracow, Poland, between 1987 and 1988. The period between the onset of the first symptoms and the actual commencement of the treatment spanned no more than 9 months. The follow-up period was no shorter than 5 years. Histologically confirmed metastases in the regional lymph nodes were found in 16 patients. The histologic grading and tumor front grading was pursued in all cases. Fourteen parameters of the nuclei were studied with the aid of a computer-assisted system of image analysis. The morphometric parameters and the histoclinical factors were analyzed by the χ2 test and the step-wise logistic regression. It was established that nuclear area ≥66 um (P = 0.042), perimeter ≥32 um (P = 0.087), optical density ≥22,500 (P = 0.027), long axis ≥10.15 um (P = 0.025), short axis ≥7.3 um (P = 0.003), TFG assessed (≥15 points) and tumor advancement (T3, T4) were related to more frequent metastases to the lymph nodes. The morphometric parameters of the greatest significance were short axis and optical density. The quantitative morpho-metric analysis could prove a useful tool in predicting metastases to the lymph nodes.