Department of Industrial Engineering and Mathematical Sciences (DIISM), Polytechnic University of the Marche Region, Ancona 60020, Italy.
Section of Pathological Anatomy, School of Medicine, Polytechnic University of the Marche Region, United Hospitals, Ancona 60020, Italy.
Hum Pathol. 2014 Apr;45(4):745-52. doi: 10.1016/j.humpath.2013.10.034. Epub 2013 Nov 15.
The aim of the study was to identify subtle changes in the so-called architectural predominant order in nonrecurrent and recurrent papillary urothelial neoplasm of low malignant potential (PUNLMP). Quantitative analysis was performed with a software package written in LabVIEW (National Instruments, Austin, TX) in DAXX-immunostained tissue sections. Twelve cases of PUNLMP with papillary fronds sectioned lengthwise through the core were investigated and subdivided as follows: 7 nonrecurrent and 5 recurrent PUNLMP cases. Six cases of normal urothelium (NU) were included. When an epithelial thickness threshold is set at 108 μm (ie, 400 pixels), there is a complete separation between NU and PUNLMP; however, nonrecurrent and recurrent cases fall in the same range of thickness. In setting a nuclear elongation factor threshold at 2.1, there are differences between the 2 PUNLMP groups, recurrent PUNLMP and NU cases, showing a somewhat similar proportion of elongated nuclei. The nuclear orientation separates nonrecurrent from recurrent PUNLMP groups; however, NU cases do not appear as a separate group from the 2 PUNLMP groups. In combining epithelial thickness, nuclear elongation, and orientation in a multivariate analysis, the 2 PUNLMP groups appear separate between them and from NU. NU is less thickened than the 2 PUNLMP groups and shows a combination of elongated and less elongated nuclei. Elongated nuclei are more numerous in nonrecurrent PUNLMP, whereas the nuclei in recurrent PUNLMP are less elongated and less polarized than in the other group. Such finding can be used routinely to identify those PUNLMP patients who will have recurrence.
本研究旨在识别低恶性潜能非复发性和复发性乳头状尿路上皮肿瘤（PUNLMP）中所谓的建筑优势顺序的细微变化。使用在 LabVIEW（National Instruments，Austin，TX）中编写的软件包对 DAXX 免疫染色组织切片进行定量分析。研究了 12 例纵向切开乳头状叶的 PUNLMP 病例，并分为以下几类：7 例非复发性和 5 例复发性 PUNLMP 病例。纳入 6 例正常尿路上皮（NU）病例。当上皮厚度阈值设置为 108 μm（即 400 像素）时，NU 和 PUNLMP 之间有完全分离；然而，非复发性和复发性病例的厚度落在相同范围内。当核伸长因子阈值设置为 2.1 时，在 2 组 PUNLMP 中，复发性 PUNLMP 和 NU 病例之间存在差异，显示出相似比例的伸长核。核取向将非复发性与复发性 PUNLMP 组分开；然而，NU 病例似乎并未与 2 组 PUNLMP 分开。在多变量分析中结合上皮厚度、核伸长和取向，2 组 PUNLMP 彼此分开，与 NU 分开。NU 比 2 组 PUNLMP 薄，显示出伸长和非伸长核的组合。非复发性 PUNLMP 中伸长核的数量更多，而复发性 PUNLMP 中的核则比其他组的核伸长程度更低，极性也更低。这种发现可以常规用于识别那些会复发的 PUNLMP 患者。
