[The prognostic value of mean nuclear area and mean nuclear volume in bladder cancer]

To evaluate the prognostic value of mean nuclear area (MNA) and mean nuclear volume (MNV) in bladder cancer, a retrospective study was performed comprising 67 bladder cancer patients who could be followed up for more than 3 years. Cosmozone 1SA, a Nikon image analyzing system was used for the morphometric study. The specimen of initially biopsied tumor tissue was set in an Olympus microscope at 400-fold magnification, and the image was superimposed on the monitor picture through a video camera attached to the microscope. MNA and MNV were measured by tracing the contour of the nucleus which were selected by the point-sampled intercept methods. The time required for measurement of the area and volume was about 15 minutes per case. MNA in cases with histological grade 1, 2 and 3 were 35 +/- 3 microns2 (mean +/- SD), 42 +/- 10 microns2 and 62 +/- 12 microns2 respectively. MNV with grade 1, 2 and 3 were 282 +/- 46 microns3, 371 +/- 148 microns3 and 644 +/- 182 microns3 respectively. The morphometric results were significantly related to histological grade. In cases with a value of MNA of 40 microns2 or more and/or a value of MNV of 370 microns3 or more, the proportion of cases who underwent cystectomy or died of cancer was significantly high and demonstrated poor survival. In contrast, those who showed MNA and MNV less than the above value had better prognosis. These results suggest that the measurements of MNV seems to be useful for objectively evaluating the malignant potential of bladder cancer.