Mean nuclear volume of bladder cancer: stereological estimation and its clinical value

Mean nuclear volumes (MNVs) of bladder cancer cells from the specimens of 100 patients were estimated by stereological procedure. The value of MNVs of bladder cancer were ranged widely, from 114.6 to 1,041.9 microns3. However, strong correlation was observed between MNV and histopathological grade and stage. Furthermore, the MNV predicts the biological behavior including the malignant potential and prognosis of the patient. Patients with MNV below 315 microns3 had significantly better prognosis than those with MNV above this value (p < 0.01). The 5- and 10-year survival rates for patients with MNV below 315 micron3 were both 97%, while those for patients with MNV above 315 microns3 were 65 and 58%, respectively. MNVs of the recurrent tumors were significantly increased, compared with those of the initial tumors (p < 0.01). MNV of extirpated tumor specimens following chemotherapy consisting of cisplatin and Adriamycin through balloon-occluded arterial infusion (BOAI) was significantly decreased, compared with that before BOAI (p < 0.01). We conclude that the MNV is an excellent predictor for the prognosis of the patient and the tumor recurrence. Furthermore, the stereological estimation of nuclear volume is a simple, quick, inexpensive, and reliable method to assess quantitative analysis of the histological and biological character of bladder cancer.