Yokoyama Toshiro, Kawahara Akihiko, Kage Masayoshi, Kojiro Masamichi, Takayasu Hideki, Sato Takashi
Department of Pathology, Kurume University Hospital, Japan.
Diagn Cytopathol. 2005 Aug;33(2):71-7. doi: 10.1002/dc.20309.
To establish diagnostic criteria using comparison of cell cluster shapes, between benign and malignant tumors, breast tumors demonstrating weak cellular atypia in low grade invasive ductal carcinoma (IDC) were compared. Fine-needle aspiration (FNA) specimens of breast tumors were obtained from 37 patients. Among these, 16 were histologically diagnosed as IDC low-grade and the other 21 as benign fibroadenoma (FA). For evaluation, we examined 740 clusters from these 37 FNA specimens. Nine image morphometric parameters were studied, including the cluster area, circumference, maximal length, maximal breadth, ratio of length to breadth, cluster roundness, cluster size, and the edge and distribution image fractal dimensions for cluster analysis. We evaluated the irregularity in cell cluster shape using fractal dimension analysis, and determined the correlation to cluster size. The irregularity in the IDC cluster shape was higher than that in the FA cluster shape. However, six cases (28.5%) of 21 FA clusters showed high fractal dimensions similar to those for IDC. The clusters were classified by cluster analysis into three types: IDC clusters, FA with irregular cluster shape, and FA with no irregular clusters. The average cell cluster area of the FA with irregular shape was found to be about three times larger than that of IDC clusters. When the differential diagnosis between IDC and FA is difficult, it is important to focus on irregularities in the shape and on overall size of the cell clusters. For accurate diagnosis, the cell cluster shape is as important as the individual cellular atypia.
为了通过比较细胞团簇形状来建立良性和恶性肿瘤之间的诊断标准，对低级别浸润性导管癌（IDC）中显示细胞异型性较弱的乳腺肿瘤进行了比较。从37例患者获取了乳腺肿瘤的细针穿刺（FNA）标本。其中，16例经组织学诊断为低级别IDC，另外21例为良性纤维腺瘤（FA）。为了进行评估，我们检查了这37个FNA标本中的740个细胞团簇。研究了9个图像形态计量学参数，包括团簇面积、周长、最大长度、最大宽度、长宽比、团簇圆度、团簇大小以及用于团簇分析的边缘和分布图像分形维数。我们使用分形维数分析评估细胞团簇形状的不规则性，并确定其与团簇大小的相关性。IDC团簇形状的不规则性高于FA团簇形状。然而，21个FA团簇中有6例（28.5%）显示出与IDC相似的高分形维数。通过团簇分析将团簇分为三种类型：IDC团簇、具有不规则团簇形状的FA以及无不规则团簇的FA。发现具有不规则形状的FA的平均细胞团簇面积约为IDC团簇的三倍。当IDC和FA之间的鉴别诊断困难时，关注细胞团簇的形状不规则性和整体大小很重要。为了准确诊断，细胞团簇形状与个体细胞异型性同样重要。
