Stereologic estimation of nuclear volume in glottic squamous-cell carcinoma

By means of a newly developed stereologic model, the point sample intercept technique, we estimated the mean nuclear volume (nuclear (V) over bar v) in 106 T1-4 glottic carcinomas. The original formalin fixed, routinely processed H&E stained diagnostic sections were used. The overall average nuclear (V) over bar v was 782 mu m(3). Neither T- nor N-stage revealed significant differences in nuclear (V) over bar v. Patients dying from glottic carcinoma had a higher nuclear (V) over bar v compared to survivors/patients dying from intercurrent diseases, 917 and 713 mu m(3) respectively (p=0.0042). The distribution of nuclear (V) over bar v suggested that a cut-off level of 900 mu m(3) would give a better separation between clinically favourable and poor prognostic cases (p=0.0004). Both T- and N-stage were highly significant in relation to survival by univariate analysis. Multivariate analysis retained only N-stage (p=0.0001) and nuclear (V) over bar v (p=0.0022). Our results suggest that nuclear (V) over bar v is a strong independent prognostic marker in glottic carcinomas.