Relation of Nuclear Morphometry with Clinicopathologic Prognostic Parameters and Immunohistochemical ER, PR and Cerb-B2 Expressions in Breast Carcinoma

Purpose: Computerized histomorphometric analyses have been widely used as a diagnostic tool for the differential diagnosis of various tumors including breast carcinoma, as well as the grading of malignant tumors and evaluation of prognosis and therapeutic response. The aim of the present study is to determine the association between nuclear morphometric variables and clinicopathologic prognostic parameters including ER, PR, and Cerb-B2 expressions in breast carcinoma. Materials and Methods: A hundred and five patients with breast carcinoma were evaluated in terms of various nuclear morphometric parameters, including mean nuclear area (MNA), mean nuclear perimeter (MNP), mean nuclear long diameter (MNLD), and mean nuclear short diameter (MNSD). Fifty tumor cell nuclei, per lesion, on Hematoxylen eosin-stained slides were measured using a digital image analysis system. The relation between calculated data and clinicopathologic prognostic parameters were assessed with statistical methods. Results: Among histologic subtypes, invasive ductal carcinoma (IDC) had higher MNLD than other tumors group (p=0.04). Grade III IDC had higher MNA (p=0.04) and MNSD (p=0.02) than grade I IDC and higher MNA (p=0.01), MNP (p=0.02), MNLD (p=0.01), and MNSD (p=0.02) than invasive lobular carcinoma. MNA (p=0.01), MNP (p=0.009), MNLD (p=0.01), and MNSD (p=0.006) were higher in tumors having necrosis than tumors without necrosis. Immunohistochemically, Cerb-B2 positive tumors exhibited higher MNA (p=0.001), MNP (p=0.001), MNLD (p=0.001) and MNSD (p=0.001) than Cerb-B2 negative tumors. Conclusion: Nuclear morphometric assessment, especially using MNA, is a valuable tool due to its significant association with clinicopathologic prognostic parameters including tumor grade, histologic subtype, tumor necrosis and Cerb-b2 expression profile.