Objective: To investigate the influence of nuclear morphology of tumor cells on survival time of patients with primary glioblastomas.
Study design: Tumor cell nuclei have been measured in paraffin sections from 51 glioblastomas (Ki-67 immunostaining). In each tumor, the region with the highest proliferative activity has been selected for performing the morphometric analysis. Nuclear area, shape variables (roundness factor, Fourier amplitudes) and the proliferation index Ki-67 have been determined. Statistical relationships between these variables have been tested by principal component analysis and Spearman's correlation analysis. The survival time has been tested using Kaplan-Meier analysis. The influence of morphometric variables on survival time and on the time until recurrence has been tested by Cox analysis.
Results: There is a significant correlation of mean value and standard deviation of nuclear area with shape variables. Cox analysis showed a significant influence of the quantitative morphologic variables on survival time for patients with and without complete surgical resection. For patients with complete surgical resection, there was a distinct influence of mean nuclear area on survival time. Patients with incomplete surgical resection of the tumors had a significantly shorter survival. No significant influence of the variables on the time from surgery to recurrence could be shown.
Conclusion: Quantitative morphology of tumor cell nuclei in our set of glioblastoma cases showed a statistically significant relation with the survival time of the patients, indicating the biological significance of nuclear morphology in glioblastomas.