Affiliations: Edinger Institut für Neurologie, Klinikum der
Johann Wolfgang Goethe-Universität, D-60528 Frankfurt/Main | Institut für Biometrie, Medizinische Hochschule,
D-30625 Hannover
Note: [] Author of correspondence: Dr. R.Nafe Edinger Institut für
Neurologie Klinikum der Johann Wolfgang Goethe-Universität
Deutschordenstraße 46 D-60528 Frankfurt / Main, Germany
Abstract: Tumor cell nuclei in 161 primary resected astrocytic tumors have
been analyzed by means of digital image analysis together with the
determination of the proliferation index Ki-67. All cases had been reevaluated
retrospectively by two histopathologists and were typed and graded according to
the WHO-classification of central nervous system tumors: Pilocytic astrocytomas
(n=5), diffuse astrocytomas grade II (n=15), anaplastic astrocytomas grade III
(n=44) and glioblastomas grade IV (n=97). The main aim was to contribute to the
question, whether planimetric variables are of primary importance in grading of
astrocytic tumors and to test the degree of statistical separation of the
different tumor grades. There was a nearly 100% correct reclassification of all
astrocytomas by means of discriminant analysis with the exception of one single
case. This result was achieved exclusively by shape variables determined by
Fourier-analysis. The variability of nuclear shape within the single tumor case
showed a less pronounced contribution to grading than mean and median values of
shape variables. In contrast, nuclear size, variation of nuclear size and
proliferation index showed a considerable overlap between the tumor grades.
Different from astrocytomas, glioblastomas revealed a pronounced heterogeneity
of nuclear morpholgy. The detailed analysis of nuclear shape by means of
Fourier-analysis provided a better separation of the tumor grades than a simple
shape factor. Together with other reports on quantitative morphological
analyses of astrocytic tumors, the results provide a realistic perspective for
a quantitatively assessed grading of astrocytic tumors, especially for the
differentiation between astrocytomas grade II and III according to the
WHO-classification.
