Utility of nuclear morphometry in serous ovarian carcinoma and its correlation with grades

Abstract

Dibyajyoti Boruah, V. Manu, Tin Aung Hein, V. S. Nijhawan

Objective: The main objectives of this study were: To evaluate nuclear major axis (MAJX) and minor axis (MINX), nuclear area (NA), nuclear perimeter (NP), nuclear aspect ratio (NAR), and nuclear roundness (NR) with their variability using morphometric techniques in malignant and benign ovarian tumors and to correlate them with histological grades. Methods: Morphometric parameters were evaluated in 8 low-grade (LG) and 22 high-grade (HG) serous ovarian carcinoma and 30 benign grade (BG) cases by digital image morphometric technique using histological sections. Results: The mean of the size-related nuclear parameters: MAJX, MINX, NA, NP, and their variability were statistically significantly greater (P < 0.01) in malignant cases than benign, whereas mean NAR and its variability were significantly lower in malignant cases. Mean NR was significantly higher but its variability (standard deviation - NR) was significantly lower in malignant cases. Histological grade exhibited strong positive correlation with MAJX (ρ = 0.864), MINX (ρ = 0.882), NA (ρ = 0.875), NP (ρ= 0.859), and moderate positive correlation with NR (ρ = 0.682); unlike NAR (ρ = −0.794). Except NR, all other parameters showed positive correlation with their variability. Mean MINX and NA in HG tumor were statistically significantly higher (P < 0.05). For all malignant cases: MINX > 5.03 µm and NA > 30.44 µm2 can be used to differentiate from benign with 100% efficiency. Conclusion: Morphometric parameters related to nuclear size and their variability were significantly larger in malignant cases than the benign and showed strong positive correlation with the grades. Nuclear shapes of the malignant nuclei were rounder than the benign. Nuclear morphometry can be gainfully exploited in the diagnosis of ovarian carcinoma quantitatively