Abstract
In the present study we evaluated the prognostic impact of both DNA cytometry and quantitative histology in patients with malignant melanoma (MM). In contrast to previous investigations on sections, rapid image analysis (IA) of imprint specimens was performed to measure DNA cytometric features; 34 cases of stage I MM with low (<1.5mm, n = 20) and higher tumor thickness (TTH) (>1.5mm, n = 14) were analyzed.
We found significant correlations between cytometric features and TTH, which is accepted as the most important prognostic criterion in MM. Higher TTH was closely correlated with the rate of markedly aneuploid nuclei, which is indicated by the 5c exceeding rate (5cER; r, 0.89; p < 0.001). The gain of chromatin in thicker tumors was accompanied by higher mean nuclear area (MAREA; r, 0.60; p < 0.001) and mean DNA content (MDNA; r, 0.58; p < 0.001).
Additional evidence for prognostic significance of cytometry was obtained by preliminary survival analysis of 16 cases (four patients died within 2½ years and 12 patients survived for at least 4½ years). Applying multivariate stepwise discriminant analysis, a combination of TTH, level of invasion (LEV), 2c deviation index (2cDI), and modified standard deviation of the DNA values (SDNAM) proved to be most effective. One hundred percent of the cases were correctly classified as survivors or nonsurvivors. TTH and the 5cER were found to be the best univariate criteria for prognosis. In the U test according to Mann and Whitney, a significant discrimination of survivors and nonsurvivors was possible using either TTH or the 5cER, respectively (p < 0.02).
Thus, we would like to conclude that IA of imprint specimens can be recommended as a rapid and simple additional method for grading.
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References
Balch CM (1992) Cutaneous melanoma: prognosis and treatment results worldwide. Semin Surg Oncol 8:400–414
Bartkowiak D, Otto F, Schuman J, Lippold A, Drepper H (1991) Sequential DNA flow cytometry in metastatic malignant melanoma. Oncology 48:154–157
Binder M, Dolezal I, Wolff K, Pehamberger H (1992) Stereologic estimation of volume-weighted mean nuclear volume as a predictor of prognosis in “thin” malignant melanoma. J Invest Dermatol 99:180–183
Bines SD, von Roenn JH, Kheir SM, Coon JS (1988) Flow cytometry in melanoma. In: Nathanson L (ed) Malignant melanoma: biology, diagnosis, and therapy. Kluwer Academic, Boston, pp 155–169
Björnhagen V, Auer G, Lagerlöf B, Erhardt K, Mansson-Brahme E (1991) Nuclear DNA analyses in archival material from primary malignant melanoma. A pilot study. Anal Quant Cytol Histol 13:335–342
Böhm N (1968) Einfluß der Fixierung und der Säurekonzentration auf die Feulgen Hydrolyse bei 28°C. Histochemie 14:201–211
Breslow A (1970) Thickness, cross-sectional areas and depth of invasion in the prognosis of cutaneous melanoma. Ann Surg 172:902–908
Clark WH Jr, From L, Bernardino EA (1969) The histogenesis and biologic behavior of primary human malignant melanomas of the skin. Cancer Res 29:705–726
Gattuso P, Reddy V, Solans E, Kathuria S, Araha GV, Jacobs HK, Walloch J (1990) Is DNA ploidy of prognostic significance in stage I cutaneous melanoma? Surgery 108:702–709
Hansson J, Tribukait B, Lewensohn R, Ringborg U (1982) Flow cytofluorometric DNA analyses of metastases of human malignant melanomas. Anal Quant Cytol 4:99–104
Heenan PJ, Jarvis LR, Armstrong BK (1989) Nuclear indices and survival in cutaneous melanoma. Am J Dermatopathol 11:308–312
Kaern J, Wetteland J, Trope CG, Farrants GW, Juhn SW, Pettersen EO, Reith A, Danielsen HE (1992) Comparison between flow cytometry and image cytometry in ploidy distribution assessments in gynecologic cancer. Cytometry 13:314–321
Leitinger G, Cerroni L, Soyer HP, Smolle J, Kerl H (1990) Morphometric diagnosis of melanocytic skin tumors. Am J Dermatopathol 12:441–445
Lindholm C, Hofer PA, Jonsson H (1990) Single cell DNA cytophotometry in clinical stage I malignant melanoma. Relationship to prognosis. Acta Oncol 29:147–150
Mukonen T, Pyrkonen S, Laasonen A, Asko-Seljavaara S, Franssila K (1991) DNA aneuploidy and low S-phase fraction as favourable signs in metastatic melanoma. Br J Cancer 64:749–752
Onishi K, Ishikawa H (1991) Flow cytometric DNA analysis of primary cutaneous malignant melanoma. Acta Derm Venereol (Stockh) 71:525–528
Ploem-Zaajer JJ, van Driel-Kulker AM, Mesker WE, Cornelisse CJ (1987) Advantages and limitations of retrospective DNA cytometry by flow and image analysis. In: Burger G, Ploem JS, Goerttler K (eds) Clinical cytometry and histometry. Academic, London, pp 176–179
Rode J, Williams RA, Dhillon AP, Moss E (1991) Nuclear DNA profiles in primary melanomas and their metastases. Cancer 67:2333–2336
Ronan SG, Han MC, Das Gupta TK (1988) Histologic prognostic indicators in cutaneous melanoma. Semin Oncol 15:558–565
Rowley MJ, Cockerell CJ (1991) Reliability of prognostic models in malignant melanoma. Am J Dermatopathol 13:431–437
Ruiter DJ (1992) Clinical and pathologic diagnosis, staging and prognostic factors of melanoma and management of primary disease. Curr Opin Oncol 4:357–367
Schmiegelow P, Oppermann T, Nüßgen A, Schroiff R, Jänner M (1987) Melanoma in situ adjacent to an invasive nodular melanoma and metastases — DNA — cytophotometry, mitotic index, and anisokaryosis. Vichows Archiv [A] 411:871 – 2873
Schmoeckel C, Braun-Falco O (1978) Prognostic index in malignant melanoma. Arch Dermatol 114:871–873
Soong SJ, Shaw HM, Balch CM, McCarthy WH, Urist MM, Lee JY (1992) Predicting survival and recurrence in localized melanoma: a multivariate approach. World J Surg 16:191–195
Vogt T, Stolz W, Braun-Falco O, Kaudewitz P, Eckert F, Abmayr W, Dummer R, Burg G (1991) Prognostic significance of DNA cytometry in cutaneous malignant lymphomas. Cancer 68:1095–1100
Wied GL, Bartels PH, Bibbo M, Dytch HE (1989) Image analysis in quantitative cyto- and histopathology. Hum Pathol 20:549–71
Zaloudik J, Moore M, Ghosh AK, Mechl Z, Rejthar A (1988) DNA content and MHC class II antigen expression in malignant melanoma: clinical course. J Clin Pathol 41:1078–1084
Zeng QS, Fu YS, Alistair A, Cochran J (1990) Nuclear DNA measurements of metastatic melanoma by a computerized digital imaging system. Hum Pathol 21:1112–1116
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Vogt, T., Stolz, W., Hohenleutner, U., Schiffner, R., Landthaler, M. (1995). Prognostic Significance of DNA Cytometry in Comparison with Histologic Measurements in Malignant Melanomas. In: Garbe, C., Schmitz, S., Orfanos, C.E. (eds) Skin Cancer: Basic Science, Clinical Research and Treatment. Recent Results in Cancer Research, vol 139. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-78771-3_14
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DOI: https://doi.org/10.1007/978-3-642-78771-3_14
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