Rumalla A, Baron T H, Leontovich O, Burgart L J, Yacavone R F, Therneau T M, de Groen P C, Sebo T J
Division of Gastroenterology and Hepatology and Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
Mayo Clin Proc. 2001 Jan;76(1):29-33. doi: 10.4065/76.1.29.
To evaluate the accuracy of digital image analysis (DIA) for distinguishing between benign and malignant strictures of the biliary tract.
Our pathology databank was used to identify all biliary brush cytology specimens obtained during endoscopic retrograde cholangiopancreatography between June 1997 and June 1999. Corresponding medical records were reviewed to determine whether patients had benign or malignant strictures. Strictures were further classified into benign strictures with negative routine cytology, malignant strictures with negative routine cytology, and malignant strictures with positive routine cytology. Papanicolaou-stained smears of available brush cytology specimens were destained and then restained with Feulgen dye. Nuclear images were quantified for DNA content without knowledge of stricture type. DNA histograms were generated and ploidy results compared with the class of stricture.
We analyzed 27 specimens from 69 confirmed benign or malignant strictures. Assuming that the presence of any aneuploid cells indicated malignancy, the sensitivity of DIA was 85%. Furthermore, aneuploid cells were detected by DIA in 13 of 16 specimens in which routine cytology was unrevealing.
Ploidy assessment by DIA has potential to enhance the sensitivity of diagnosing malignant strictures compared with routine cytology alone.
评估数字图像分析（DIA）区分胆道良性和恶性狭窄的准确性。
利用我们的病理数据库，识别1997年6月至1999年6月期间在经内镜逆行胰胆管造影术中获取的所有胆道刷检细胞学标本。查阅相应的病历以确定患者患有良性还是恶性狭窄。狭窄进一步分为常规细胞学检查阴性的良性狭窄、常规细胞学检查阴性的恶性狭窄以及常规细胞学检查阳性的恶性狭窄。对可用的刷检细胞学标本的巴氏染色涂片进行脱色，然后用福尔根染料重新染色。在不知道狭窄类型的情况下，对细胞核图像的DNA含量进行定量分析。生成DNA直方图，并将倍性结果与狭窄类别进行比较。
我们分析了69例确诊为良性或恶性狭窄患者的27份标本。假设存在任何非整倍体细胞即表明为恶性肿瘤，DIA的敏感性为85%。此外，在16份常规细胞学检查未发现异常的标本中，DIA检测到13份存在非整倍体细胞。
与单纯常规细胞学检查相比，通过DIA进行倍性评估有可能提高诊断恶性狭窄的敏感性。
