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The reproducibility of the DNA index of paraffin wax sections from 44 follicular tumours of the thyroid (18 follicular adenomas and 26 follicular carcinomas), which had been assessed by flow cytometry was analysed in two laboratories, using consecutive sections of the same specimens and two different commercially available flow cytometers. Two slightly different cell preparation and staining techniques were used in the two laboratories. Using strictly defined criteria the histograms were classified blind as diploid, peritetraploid, aneuploid, or inadequate and insufficient by two independent investigators. Both the concordance between the two different flow cytometers and the agreement of duplicate assessments within the same flow cytometers were assessed. The mean coefficient of variation of the G0/G1 peak of the diploid tumours in the PARTEC flow cytometer was 5.5 (range 2.3-9.8) and in the FACS flow cytometer 5.2 (range 3.7-8.3); this difference was not significant. There was concordance of classification between the two laboratories in 35 of 36 cases. In 25 cases (18 diploid, seven aneuploid) the intralaboratory variation showed a 100% concordance in histogram classification. It is concluded that flow cytometer DNA index assessment of follicular tumours of the thyroid is reproducible and can be used to evaluate the discriminating and prognostic value of this feature. [ABSTRACT FROM PUBLISHER]

In a prospective study the predictive value of a multivariate morphometric prognostic index was evaluated in 195 patients with primary breast cancer who had not been treated with any form of chemotherapy or hormonal treatment. The presence or absence of distant tumour recurrence combined with the scores of the prognostic index were compared with the survival curves predicted in a previous study. The value of the presence of lymph node metastases, number of positive nodes, tumour size, mitotic activity index, and oestrogen receptor status in prediction of prognosis were also investigated. In agreement with the results of the previous retrospective study, the prospective use of the index had the strongest predictive prognostic value, followed by the mitotic activity index. Statistical analysis showed that the actual prognoses of 43 of the 195 patients (22%) were more accurately determined by the prognostic index rather than by using the presence of the lymph node metastases as the classifying variable. The prognostic index is consistently reproducible by different technicians; it is a reliable method of predicting distant recurrence of tumour and hence the prognosis of patients with primary breast carcinoma. It provides more prognostic information than the presence of lymph node metastases alone, and the index should be incorporated in routine pathology reports. [ABSTRACT FROM PUBLISHER]

The prognostic value of clinical, quantitative, and qualitative microscopical features of both the primary tumour and also of the affected lymph nodes were investigated in 71 patients with breast cancer with spread to lymph nodes (T X N + M0). Age, tumour size, and localisation of the tumour comprised the clinical features; morphometry included assessment of the cellularity index, the mitotic activity index, and seven nuclear indices; the qualitative features investigated were histological type and grade, nuclear grade, oestrogen receptor content, number of lymph nodes affected, capsule infiltration of the nodes, presence of metastatic deposits in the efferent lymph vessels, percentage area of lymph node occupied by tumour. Immunohistochemistry was performed to show the presence of carcinoembryonic antigen and peanut agglutinin. All the patients had a minimum follow up of 24 months (maximum 48 months, mean 36 months). Analysis of the results showed that the combined results of morphometry (of the primary tumour and the axillary lymph node metastatic deposits) yielded more information than analysis of axillary lymph node state, or morphometry of the primary tumour, or the lymph node metastases alone. Patients with a nuclear axes ratio of greater than 1.41 in the primary tumour and greater than 1.36 in the lymph node metastatic deposits were less likely to develop distant metastases than patients with values below any of these thresholds (recurrence rates 5.2% and 46%, respectively). Thus the preliminary results of this prospective study indicate that morphometry provides important prognostic information in patients with breast cancer that has spread to lymph nodes. [ABSTRACT FROM PUBLISHER]

Serum carcinoembryonic antigen concentrations (serum CEA) in 80 patients with primary breast cancer were measured preoperatively, one month after operation, and thereafter serially every third month. These data were related to histological and morphometric features of the primary breast carcinoma and the lymph node metastases and to clinical follow up data. Analysis of the serum CEA values showed significant correlations with size of tumour, the presence of lymph node metastases, oestrogen receptor, and occurrence of distant metastases. Furthermore, the results indicated that serial determination of serum CEA in the first two years after operation may be useful in monitoring for the occurrence of distant metastases in patients with metastatic spread to lymph nodes and with large (greater than or equal to 2 cm) primary breast tumours positive for oestrogen receptor. In agreement with other studies, however, it was found that the predictive value of serum CEA concentrations in general is weak and costs may prohibit the implementation of the routine assessment of CEA concentrations. [ABSTRACT FROM PUBLISHER]