Desmoplasia measured by computer assisted image analysis: an independent prognostic marker in colorectal carcinoma - PubMed (original) (raw)

Desmoplasia measured by computer assisted image analysis: an independent prognostic marker in colorectal carcinoma

B Sis et al. J Clin Pathol. 2005 Jan.

Abstract

Aims: The assessment of desmoplasia by traditional semiquantitative methods does not provide reliable prognostic data. The aim of this study was to quantify desmoplasia by computerised image analysis in primary colorectal carcinomas and to investigate its ability to predict overall survival.

Methods: In total, 112 colorectal adenocarcinomas, with a median follow up of 66 months, were studied. The representative tumour sections were stained by the van Gieson method, which stains collagen rich stroma red. For quantitative histochemical measurement, digital images were analysed by a computerised image analysis program to calculate the percentage of red stained tissue area. The percentage of desmoplasia (PD) was related to conventional clinicopathological prognostic factors and overall survival.

Results: The mean (SD) PD was 4.85 (3.37). PD was found to be significantly associated with lymph vessel and venous invasion. By Kaplan-Meier analysis, PD was associated with survival-patients with PD > 4 had a shorter survival than those with PD </= 4. In multivariate analysis, tumour stage, distant metastasis, and PD emerged as independent prognostic factors.

Conclusion: Desmoplasia measured by image analysis seems to be a significant prognostic indicator in patients with colorectal carcinoma and the improved method described in this study would be useful for routine prognostication.

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Figures

Figure 1

Figure 1

Section of colorectal carcinoma stained with van Gieson (A) before and (B) after the selection of red colour.

Figure 2

Figure 2

Intraobserver agreement on the measurement of percentage of desmoplasia (PD). Test statistics: Spearman’s rank correlation test, r = 0.97, p ⩽ 0.001.

Figure 3

Figure 3

Interobserver agreement on the measurement of percentage of desmoplasia (PD). Test statistics: Spearman’s rank correlation test, r = 0.98, p ⩽ 0.001.

Figure 4

Figure 4

Mean percentage of desmoplasia in tumours in relation to clinical stage of disease.

Figure 5

Figure 5

The distribution of lymphatic invasion in tumours according to the percentage of desmoplasia.

Figure 6

Figure 6

The distribution of venous invasion in tumours according to the percentage of desmoplasia.

Figure 7

Figure 7

Variation in the percentage of desmoplasia (PD) at each value of the semiquantitative grades for desmoplasia.

Figure 8

Figure 8

Kaplan–Meier overall survival curves for 112 patients with colorectal carcinoma grouped according to their percentage of desmoplasia (PD). Test statistics: log rank test (one degree of freedom), p = 0.008.

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