The use of nuclear morphometry to predict response to therapy in Wilms' tumor

Using nuclear morphometric analysis, a retrospective study was made of 27 patients with Wilms' tumor. The blinded group consisted of 17 patients with Stage I and II favorable‐histology Wilms' tumors who did not respond to therapy and ten patients with Stage III and IV favorable‐histology Wilms' tumors who did respond. In this complex group of patients, multivariate analysis (with several morphologic descriptors) was used to predict which patients responded to therapy. No single‐shape descriptor predicted the response to therapy (P > 0.5). However, three shape descriptors: maximum ellipticity (ME), standard error of bending energy (SEBE), and the range of chain code‐maximum peak (RCCM), with the multivariate formula of (1131 × SEBE) + (‐7 × ME) + (50 × RCCM) + 7.18, separated the two groups (P < 0.004). This result was statistically significant. Using this multivariate equation and a cutoff value of 0.6 units, this test yielded a sensitivity of 94% and a specificity of 70%. This result, in a complex group of patients, suggests that nuclear morphometry may be useful in the initial assessment of patients with Wilms' tumor and warrants further analysis.