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Related Experiment Videos

How to count mitoses in bladder cancer grading?

P K Lipponen1, M J Eskelinen

  • 1Department of Pathology, University of Kuopio, Finland.

Anticancer Research
|March 1, 1991
PubMed
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Correcting the mitotic index (M/V index) for nuclear area (NA) in bladder cancer improved prognostic accuracy, especially for advanced tumors. This NAM/V index better predicts tumor behavior and recurrence-free survival than the original M/V index.

Area of Science:

  • Uropathology
  • Oncology
  • Biomarker Research

Background:

  • The mitotic index (M/V index) is a prognostic indicator in bladder cancer.
  • Estimating cellularity using mean nuclear area (NA) may refine prognostic markers.

Purpose of the Study:

  • To evaluate if correcting the M/V index for NA enhances its prognostic value in bladder cancer.
  • To compare the predictive capabilities of the M/V index and the nuclear area-corrected M/V index (NAM/V index).

Main Methods:

  • Collected clinical follow-up data from 265 bladder cancer patients.
  • Measured M/V index in biopsy specimens and NA using an IBAS 1&2 image analyzer.
  • Analyzed the correlation between M/V index, NAM/V index, and clinical parameters including survival and recurrence.

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Main Results:

  • Both M/V index and NAM/V index significantly correlated with histological grade, clinical stage, and tumor progression (p < 0.0001).
  • NAM/V index demonstrated superior prognostic value (X2 = 25.5, p < 0.0001) compared to M/V index (X2 = 14.4, p = 0.0007).
  • NAM/V index showed a stronger association with recurrence-free period (p = 0.0006) than M/V index (p = 0.0823).

Conclusions:

  • Correcting the M/V index for NA (NAM/V index) improves prognostic accuracy in advanced bladder tumors.
  • While not significantly improving prognosis in superficial tumors, the NAM/V index offers better grading results for advanced cases.
  • The NAM/V index is a more robust prognosticator than the M/V index for predicting bladder cancer outcomes.