Relationships between image cytometric DNA index, proliferation fraction and multiploidy and conventional nuclear grade in breast carcinoma

Abstract

High nuclear grade, DNA aneuploidy, and elevated proliferation fraction tend to be mutually associated in breast carcinomas, defining a subset of carcinomas with more aggressive behavior. We sought to examine more closely the interrelations between nuclear grade and DNA cytometric parameters (aneuploidy, proliferation fraction, and multiploidy) in breast carcinomas based on our assumption that DNA content is the major determinant of nuclear appearances used in grading tumors. We obtained estimates of the strength of correlation (correlation and contingency coefficients) between nuclear grade and DNA index, proliferation fraction, and multiploidy within a series of 87 consecutively accessioned breast carcinoma specimens studied by conventional histologic methods and by computer-assisted image analysis of Feulgen-stained imprints. Seventy-three tumors were found to consist of a single population of cells on the cytogram (uniploid tumors). In this group, DNA index of the population and proliferation fraction were separately compared with nuclear grade by rank-order correlation. The Spearman correlation coefficient (Rs) for nuclear grade versus DNA index was 0.55 (P < 0.00006), the highest level of correlation observed between any of the parameters studied. Tumors given a nuclear grade of 1 were mostly diploid or near diploid, and Grade 3 tumors were predominantly aneuploid. However, nuclear grading did not effect a complete separation of diploid from aneuploid tumors, because assignment of intermediate grades (almost one half of the specimens) had no value in predicting ploidy status.(ABSTRACT TRUNCATED AT 250 WORDS)