Improving the prognostic value of histopathological grading and clinical staging in renal cell carcinomas by means of computer-assisted microscopy

J Pathol. 1999 Feb;187(3):313-20. doi: 10.1002/(SICI)1096-9896(199902)187:3<313::AID-PATH260>3.0.CO;2-X.

Abstract

The present work aims to refine prognosis in cases of renal cell carcinoma (RCC) by integrating a variety of parameters with the prognostic information provided by histopathological grading and clinical staging, carried out on a series of 97 RCCs. To this end, Feulgen-stained RCC cell nuclei were characterized by means of 38 variables describing nuclear DNA ploidy levels and morphology. All of these data were subjected to a principal components analysis. On the basis of this multivariate analysis, Fuhrman grade II was subdivided into grades II- and II+, and Fuhrman grade III into grade III- and III+. The same kind of subcategorization was performed in the case of the T2 and T3 clinical stages. The results show that the classification into grade II- and III- RCCs correspond to a more favourable prognosis than grade II+ and III+, to which shorter survival periods were attributable. Similar results were obtained for the subcategorization of the T2 and T3 clinical stages. Very simple biological characterizations of these grade- or stage-related RCC groups were obtained by means of a decision tree approach applied to the cytometry-generated variables. The resulting classification rules were validated on a new series of 18 patients and enabled very accurate predictions of survival.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Renal Cell / pathology*
  • Coloring Agents
  • Decision Trees
  • Female
  • Humans
  • Image Cytometry
  • Image Processing, Computer-Assisted
  • Kidney Neoplasms / pathology*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Staging
  • Ploidies
  • Prognosis
  • Rosaniline Dyes*
  • Survival Rate

Substances

  • Coloring Agents
  • Feulgen stain
  • Rosaniline Dyes