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形态学参数在乳腺病变细胞学分类中的意义

Significance of Morphometric Parameters in the Categorization of Breast Lesions on Cytology.

作者信息

Yadav Hemant, Gill Meenu, Srivastava Divya, Gupta Veena, Gupta Sumiti, Sen Rajeev

机构信息

Department of Pathology, PGIMS Rohtak, HARYANA, INDIA.

出版信息

Turk Patoloji Derg. 2015;31(3):188-93. doi: 10.5146/tjpath.2015.01327.

Abstract

OBJECTIVE

The aim of this study was to assess the utility of the morphometric parameters in cytological aspirates in the categorization of breast lesions.

MATERIAL AND METHOD

The study was carried out on 50 females presenting with a breast lump for fine needle aspiration cytology. Air-dried smears from the aspirate were stained with Leishman and Giemsa stains while alcohol-fixed preparations were stained with the PAP stain. They were subsequently categorized into benign, borderline and malignant categories on light microscopy. Morphometry was performed on the stained smears. The morphometric parameters studied were mean nuclear area, mean cytoplasmic area, perimeter and nuclear/cytoplasm ratio.

RESULTS

Morphometric parameters revealed a progressive and statistically significant increase in values from benign to borderline to malignant cases. On comparing benign with borderline and malignant, all the four parameters were found to be statistically significant with a p-value of less than 0.05 while on comparing borderline with malignant, two of the parameters, i.e. mean nuclear area and mean cytoplasmic area, were statistically significant.

CONCLUSION

This study introduces morphometry as a highly objective tool to supplement the entirely subjective fine needle aspiration cytology in the crucial differentiation of benign from malignant lesions and especially the borderline cases in the gray zone comprising of atypical ductal hyperplasia and ductal carcinoma in situ.

摘要

目的

本研究旨在评估乳腺病变分类中细胞学穿刺物形态计量学参数的效用。

材料与方法

对50例有乳腺肿块的女性进行细针穿刺细胞学检查。穿刺物的空气干燥涂片用利什曼染色和吉姆萨染色,而酒精固定制剂用巴氏染色。随后在光学显微镜下将它们分为良性、临界性和恶性类别。对染色涂片进行形态计量学分析。所研究的形态计量学参数为平均核面积、平均细胞质面积、周长和核/质比。

结果

形态计量学参数显示,从良性到临界性再到恶性病例,数值呈渐进性且具有统计学意义的增加。将良性与临界性及恶性进行比较时,发现所有四个参数均具有统计学意义,p值小于0.05;而将临界性与恶性进行比较时,两个参数,即平均核面积和平均细胞质面积,具有统计学意义。

结论

本研究引入形态计量学作为一种高度客观的工具,以补充完全主观的细针穿刺细胞学检查,用于在良性与恶性病变尤其是包括非典型导管增生和原位导管癌的灰色地带的临界性病例的关键鉴别中。

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