DNA level and stereologic estimates of nuclear volume in squamous cell carcinoma of the uterine cervix: a comparative study with analysis of prognostic impact

Article Abstract:

The grading of cancers is, at best, a subjective matter. A high-grade cancer is one which "looks" more malignant to the trained eyes of the pathologist, while a low-grade cancer looks more like tumors towards the benign end of the spectrum. Although international standards have emerged to pin down how each tumor grade should be defined, there is still some disagreement among experts on particular instances. Stereology is the highly specialized branch of microscopy which attempts to obtain quantitative estimations of the three-dimensional measurements of tissues and cells. The attempt is not trivial, since all estimates must be based on the two-dimensional slice of a three-dimensional tumor (or other tissue) which is lying under the microscope's lens. A study was conducted to evaluate the potential of stereologic measurements as prognostic factors for squamous cell cervical cancer. The findings were compared with the DNA index, an indicator of cell replication which is measured using the flow cytometer. A Cox analysis revealed that of the many factors tested, only four independent factors were necessary to provide the most accurate prognosis statistically possible. These factors were the age of the patient, the DNA index, the stage of the cancer, and the mean volume of the cell nuclei determined by stereology. The mean volume of the cancer cells of the patients who died was smaller than the mean volume found for the patients who lived. It should be mentioned, however, that the influence of the nuclear volume on patient survival was small. Although the volume of the cell nucleus might, at first, seem to be an arbitrary feature of cancerous tissue to measure, it should be remembered that changes within the cell nucleus are responsible for much of the behavior of cancer, and that changes in nuclear appearance have been routinely used by pathologists for decades as one of the features on which to base the grading of cancer cells. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Measurement, DNA, Microscopy, Medical, Medical microscopy

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Age as a prognostic factor in patients with squamous cell carcinoma of the uterine cervix

Article Abstract:

There is some uncertainty surrounding the role of age in the outcome of cervical cancer. Some studies indicate that young women have a worse prognosis than older women with this cancer, while other studies have not found a relation between age and prognosis. Among the studies that have indicated a poorer prognosis for younger women, there is some difference in the age range over which this apparent effect seems to take place. Furthermore, the women in these studies are likely to have different stages of disease and to have received different methods of treatment. To clarify the role of age in the prognosis of cervical cancer, a study was conducted to determine which tumor characteristics might be different among younger women. A total of 380 patients who underwent radical hysterectomy for cervical cancer were studied. All the women had the specific form of cancer called squamous cell carcinoma, and all had disease that was either Stage IB or more advanced. These patients were divided into age groups covering the decades from 30 to 39, 40 to 49, 50 to 59, and 60 to 69 years. The microscopic features of the cancer were examined, including the cell types, the depth of cancer invasion of the underlying tissues, the invasion of the blood vessels by the cancer, and the spread of cancer to the local lymph nodes. All of these factors are known to affect the prognosis of the disease. However, of these factors, only the spread of cancer to the lymph nodes appeared to be influenced by age. The women in the 60 to 69 age group were significantly less likely to have metastatic cancer spread to the lymph nodes than were the women in the younger age groups. Although lymph node metastasis is an indicator of poor prognosis, it was also found that among the 60- to 69-year-old women with lymph node metastases, survival was superior to comparable patients in the younger groups. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Aging, Demographic aspects

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