Peritumoral edema and karyometric variables in astrocytoma of the brain.

OBJECTIVE

The aim of this study was to evaluate karyometry as a quantitative and objective histological method by showing correlation of some karyometric variables with the severity of peritumoral edema in patients with brain astrocytoma.

METHODS

63 patients of different ages and both genders were enrolled. The patients were diagnosed with astrocytoma of the brain, histologically confirmed on the surgically removed material. Maximal tumor excision was performed in all patients, who were postoperatively treated according to current oncologic therapeutic protocols. The intensity of perifocal edema (preoperative CT scan) was correlated to the duration of survival and the values of 9 karyometric tumor variables: area, density, maximal axis, mean axis, circumference, roundness, integrated optical density and number of nuclei.

RESULTS

There were 17 cases with small perifocal edema, 19 with medium-sized and 27 with large perifocal edema, and their respective survival was around 149, 62 and 48 weeks. Those with small edema had statistically significant prolonged survival compared to those with medium and large perifocal edema (log-rank test, p=0.045). Six out of 9 karyometric variables examined were significantly related (p<0.05) to the intensity of peritumoral edema: long and mean axis, circumference, roundness, integrated optical density and number of nuclei.

CONCLUSIONS

Patients with larger peritumoral edema have shorter survival. Correlation of karyometric variables with CT findings revealed that higher degrees of tumor cellularity and nuclear wrinkling with increased integrated optical density is associated with larger peritumoral edema.