Sulindac in familial adenomatous polyposis: evaluation by nuclear morphometry.

OBJECTIVE: To find out if nuclear morphometry is a useful indicator of prognosis in patients with familial adenomatous polyposis (FAP) before and after treatment with sulindac. DESIGN: Open study. SETTING: Teaching hospital, Spain. SUBJECTS: 29 patients (17 women and 12 men) with FAP who had been treated by colectomy. There were two control groups: 17 people with healthy rectal mucosa and 10 patients with colorectal cancer. INTERVENTIONS: The 29 patients with FAP were treated with sulindac 150 mg orally twice daily for 6 months. MAIN OUTCOME MEASURES: Results of histological examination of biopsy specimens and nuclear morphometry. RESULTS: Before treatment, all patients with FAP had nuclei of cells in the rectal mucosa that were intermediate in size between those in healthy mucosa (small nuclei) and those in cancer (large nuclei). After 6 months' treatment with sulindac the patients with FAP no longer had any polyps and the size of the nuclei was similar to those in healthy mucosa. Only 1 patient failed to respond, and in this patient one of the polyps subsequently became malignant. CONCLUSIONS: Nuclear morphometry may be useful in identifying patients with FAP who are at high risk of malignant degeneration.

[Prognostic value of optic morphometry in colorectal cancer]. / Valor pronóstico de la morfometría óptica en el cáncer colorrectal.

UNLABELLED: In many types of cancer, certain morphometric characteristic of tumor cells correlate with patient survival. Our observations suggested that the survival of patients with colorectal carcinomas is negatively correlated with tumor-cell nucleus size. METHODS: We investigated relationships between postsurgery survival and nucleus morphometric in 90 patients who had undergone resection for a colorectal tumor. The nucleus-size variables considered were maximum diameter, minimum diameter, perimeter, area, and form factor (means for 100 nuclei from each patient were used in all cases). RESULTS: Our results confirmed that patients with large maximum nucleus diameter (where large = greater than the first quartile) have significantly worse survival than patients with smaller maximum nucleus diameter (mean survival, 28 vs. 43 months). Similar results were obtained for the other nucleus-size variables. Stepwise Cox regression analysis was then performed, with postsurgery survival time as the dependent variable and the following candidate independent variables: age, gender. Dukes class, degree of histologic differentiation, the various nucleus-size variables, and relative frequencies of different nucleus shapes (spherical, oval, cylindrical, fusiform, and irregular). The variables selected for the prognostic model were Dukes class, relative frequency of irregular nuclei, and maximum nucleus diameter. CONCLUSIONS: These findings indicated that nucleus size and shape are useful predictors of survival. Even in Dukes class is known, consideration of nucleus size and shape significantly improves prediction of survival.

Prognostic value of nuclear morphometry in colorectal cancer.

PURPOSE: In many types of cancer, certain morphometric characteristic of tumor cells correlate with patient survival. Our observations suggested that the survival of patients with colorectal carcinomas is negatively correlated with tumor-cell nucleus size. METHODS: We investigated relationships between postsurgery survival and nucleus morphometrics in 90 patients who had undergone resection for a colorectal tumor. The nucleus-size variables considered were maximum diameter, minimum diameter, perimeter, area, and form factor (means for 100 nuclei from each patient were used in all cases). RESULTS: Our results confirmed that patients with large maximum nucleus diameter (where large = greater than the first quartile) have significantly worse survival than patients with smaller maximum nucleus diameter (mean survival, 28 vs. 43 months). Similar results were obtained for the other nucleus-size variables. Stepwise Cox regression analysis was then performed, with postsurgery survival time as the dependent variable and the following candidate independent variables: age, gender, Dukes class, degree of histologic differentiation, the various nucleus-size variables, and relative frequencies of different nucleus shapes (spherical, oval, cylindrical, fusiform, and irregular). The variables selected for the prognostic model were Dukes class, relative frequency of irregular nuclei, and maximum nucleus diameter. CONCLUSIONS: These findings indicated that nucleus size and shape are useful predictors of survival. Even if Dukes class is known, consideration of nucleus size and shape significantly improves prediction of survival.

[Septate gallbladder and acute cholecystitis in a four-year-old girl (author's transl)]. / Vesícula tabicada y colecistitis aguda en una niña de cuatro años.

A case of a four year old girl, first seen at the emergency ward for an abdominal pain, is reported. Exploration revealed a mass at the right hypochondrium which a laparotomy labeled as a dropsy gallbladder with a complete transversal septum at the union of the gallbladder's body and infundibulum. Microscopic examination showed an acute cholecystitis. A classification of septate gallbladders is performed and embryology revised. Microphotographs of human embryo are presented making etiopathogenesis of this case understandable. The scanty bibliography on this topic makes this case extremely rare.