Abu-Eid R, Landini G
Oral Pathology Unit, School of Dentistry, The University of Birmingham, Birmingham, UK.
Histopathology. 2006 Mar;48(4):407-16. doi: 10.1111/j.1365-2559.2006.02350.x.
Granular cell tumour (GCT) is a benign tumour which occasionally induces pseudo-epitheliomatous hyperplasia (PEH) of the covering epithelium, mimicking squamous cell carcinoma (SCC) invasion. PEH cells do not show marked atypia, but the presence of pseudoinvasive patterns remains a diagnostic problem since several misdiagnosed cases have been reported. This study investigated objective morphometric criteria to distinguish GCT-PEH from SCC.
The complexity of the epithelial connective tissue interface (ECTI) in 57 profiles from nine SCC and 12 GCT-PEH cases was analysed using fractal geometry. Epithelial and non-epithelial cells were segmented using a space partition procedure and analysed morphometrically. GCT ECTI profiles were significantly more complex than those of SCC. The complexity of ECTI quantified by global and local fractal dimensions allowed up to 86% correct discrimination between GCT-PEH and SCC. The cell-wise discrimination between the two entities using cellular morphology was 76% but when the two approaches were combined, the correct discrimination was 96%.
The architectural features of GCT-PEH and SCC show differences which, when quantified, could be used to differentiate the two diagnostic classes. Characterization of these differences may help to elucidate some of the mechanisms of tumour infiltration and metastasis.
颗粒细胞瘤（GCT）是一种良性肿瘤，偶尔会导致被覆上皮的假上皮瘤样增生（PEH），酷似鳞状细胞癌（SCC）浸润。PEH细胞不显示明显异型性，但由于已有数例假诊病例报道，假浸润模式的存在仍然是一个诊断难题。本研究探讨区分GCT-PEH和SCC的客观形态学标准。
利用分形几何学分析了9例SCC和12例GCT-PEH病例的57个切片中上皮结缔组织界面（ECTI）的复杂性。采用空间分割程序对上皮细胞和非上皮细胞进行分割，并进行形态学分析。GCT的ECTI切片比SCC的明显更复杂。通过全局和局部分形维数量化的ECTI复杂性能够在GCT-PEH和SCC之间实现高达86%的正确区分。利用细胞形态学对这两种实体进行细胞水平的区分正确率为76%，但将两种方法结合时，正确区分率为96%。
GCT-PEH和SCC的结构特征存在差异，对这些差异进行量化后可用于区分这两种诊断类型。对这些差异的表征可能有助于阐明肿瘤浸润和转移的一些机制。
