Parameters of differentiation and proliferation in adult granulosa cell tumors of the ovary

We evaluated parameters of cell differentiation and proliferation to improve prognostication of ovarian adult granulosa cell tumors. Recurrent tumors (n = 10, REC group) and nonrecurrent tumors (n = 30; NED group) were compared in terms of cellular atypia, nuclear area, p53 overexpression, ploidy, DNA index, mitosis count, S-phase fraction, and nucleolar organizer region number and area per cell. Cellular atypia was significantly more frequent in REC than NED tumors (50% versus 13%; P =.03). Mean nuclear area was significantly larger in the REC than in the NED group (44 mum(2) versus 36 mum(2); P =.006). Mitotic count was significantly higher in REC than NED tumors (mean of 4.8 versus 1.7; P =.004). S-phase fraction and ploidy did not predict outcome, neither did nucleolar organizer region numbers and area per cell, or p53 overexpression. Cellular atypia and mitotic count may help in determining the prognosis of adult granulosa tumors of the ovary. The histochemical parameters evaluated did not provide additional information.