A morphometric classification of acute lymphoblastic leukemia in children

Nuclear shape and prognosis following orchiectomy in stage D2 prostate cancer

In this study, we have examined whether tumor grade and morphometric nuclear features can predict the outcome of treatment by orchiectomy in patients with stage D2 prostate cancer. Two outcome groups based on duration of survival postorchiectomy were examined, a bad outcome group of 63 patients who died from prostate cancer within 12 months and a good outcome group of 34 patients who survived beyond 5 years. Tumors were histologically classified as well (17%), moderate (17%), or poorly differentiated (66%). Tumor grade and patient outcome were significantly associated (Mann-Whitney test; P < 0.005), with 76% of poorly differentiated tumors in the bad outcome group, and 65% of well-differentiated tumors in the good outcome group. Using discriminant function analysis, tumor grade correctly predicted outcome in 70% of cases. A statistically significant difference was also detected in nuclear shape values between the two outcome groups (P < 0.05) and histological grades (P < 0.05). Using discriminant function analysis, 51% of cases were correctly classified into outcome groups using nuclear shape factors, a figure which rose to 65% when all nuclear morphometric features were used. This demonstrates that nuclear morphometric features are of no clinical value in predicting the outcome of treatment in stage D2 disease. Furthermore, these evaluations cannot select patients who might be spared orchiectomy on the basis of a predicted poor response. However, nuclear shape and variance measurements of benign glandular epithelial cells within cancerous prostates were significantly different from those of malignant cells (P < 0.005). We conclude that, while video image analysis of prostatic nuclear shape can reliably discriminate between benign and malignant cells, nuclear morphometric features are of minimal prognostic value in men with stage D2 prostate cancer treated by androgen ablation.

Ultrastructural morphometry of human leucocytes in health and disease

In this review, the literature on ultrastructural morphometry of each of the main types of human blood leucocytes has been considered, together with the technical and numerical procedures essential for valid analysis. Quantitative data have been reported for these cell types in health and comparisons have been made with those in disease states. In monocytes, and in macrophages developing from them, subtle ultrastructural differences have been detected and quantitated in malignant lymphoma; as the mononuclear phagocytes were not themselves neoplastic, the changes may have related to defects in host defence. Change in the ultrastructural characteristics of leukaemic monoblasts have also been reported. Lymphocytes and malignant lymphoid cells have been extensively investigated: differences between different types and subsets have been shown to be present in both normal lymphocytes and their malignant counterparts in leukemias and lymphomas. Particular attention has been paid to morphometric assessment of nuclear shape and size in these disorders and to its possible value as a diagnostic tool. Granulocytes have so far been the subject of few morphometric studies, although in hypereosinophilic syndrome, cellular changes have been defined and have thrown light on the abnormal pattern of degranulation. There have also been scattered reports on the cells of acute myelogenous leukaemia. The use of computers and sophisticated statistical packages has greatly facilitated the application of multiple comparison procedures and has permitted discriminant analysis to be carried out where appropriate. This review shows that ultrastructural morphometry of leucocytes will have an increasing application in clinical pathology.

The monitoring of acute leukemia patients: Part 1. Basic morphometric characteristics of bone marrow blast cells in acute lymphoblastic leukemia

Morphologic types L1 and L2 (FAB) of acute lymphoblastic leukemia were classified by computer morphometry of bone marrow blast cells in 57 patients. Measurements were made on MOP-Videoplan Analyser (Reichert) by means of cell image contouring. The decision rule that had been deduced by us on the basis of multidimensional analysis of variance in two-cell training sets, and the selection of the following combination of the best discriminating features [the discriminant coefficients are in brackets: maximal nuclear diameter (-0.338), nuclear perimeter (-6.145), cell area (-0.044), nuclear area (1.007), relative nucleoli eccentricity (-0.279), cytoplasmic/nuclear relation (-5.920) and integral nucleoli area (-0.640)] were used for computer classification of L1 and L2 blast cells. The threshold score for discriminant function in this case was -117.766. Complete clinical remission rates in L1 ALL appeared to be higher than in L2 but remission duration in those groups did not differ significantly. The morphometric parameters of leukemic cells seem to characterize their maturity or their position in cell cycle phases and may be used in acute leukemia patient monitoring.

Morphometry of macrophage development in malignant lymphoma. Predictive value of discriminant analysis

Discriminant analysis of morphometric data on the ultrastructure of developing macrophages has been used to classify 62 individual subjects into one of the 3 groups of origin, namely normal, Hodgkin's disease and non-Hodgkin's lymphoma, each finding being compared with the known diagnosis. The data had been obtained from blood monocytes grown in suspension culture over a period of 6 days, and related to whole cell, nucleus, nucleoli and mitochondria. Over 80% of subjects were correctly classified as between the 3 groups and over 90% as to their normality or otherwise. Although the non-specific nature of changes in defence cells makes it unlikely that morphometric studies of macrophages will find a place in the diagnosis of specific malignancies, the present work indicates it could be useful in assessing host response and hence prognosis and response to treatment. Discriminant analysis of quantitative differences in cell structure could have wide clinico-pathological application.

Morphometry for the prognosis of acute lymphoblastic leukemia in childhood

The morphology of acute lymphoblastic leukemia is of prognostic significance, but due to the qualitative subjective nature of the assessment, disagreement between pathologists may be considerable. In order to investigate the adjuvant potential of morphometry, the present study was undertaken. Morphometry was applied in 21 children between 2 and 10 years of age with acute lymphoblastic leukemia (ALL) with a follow-up of at least 5 years. Of these, 9 patients died, 12 (57.1%) survived for at least five years (maximally 12 years). Morphometry appeared to have an important prognostic value, independent of the FAB classification currently in use. Combination of the nuclear-cell area ratio and the cell area gave a rather good discrimination, although these quantitative data from a morphological continuum. The positive results of this pilot study point to the necessity of evaluating the data on a larger material.