通过计算机形态测量法分析良性和恶性肾上腺皮质肿瘤的组织学和免疫组化模式。
Analysis of histological and immunohistochemical patterns of benign and malignant adrenocortical tumors by computerized morphometry.
作者信息
Dalino Ciaramella Paolo, Vertemati Maurizio, Petrella Duccio, Bonacina Edgardo, Grossrubatscher Erika, Duregon Eleonora, Volante Marco, Papotti Mauro, Loli Paola
机构信息
Department of Internal Medicine, Endocrinology Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Department of Biomedical and Clinical Sciences "L. Sacco", Milan, Italy.
出版信息
Pathol Res Pract. 2017 Jul;213(7):815-823. doi: 10.1016/j.prp.2017.03.004. Epub 2017 Mar 9.
Diagnosis of benign and purely localized malignant adrenocortical lesions is still a complex issue. Moreover, histology-based diagnosis may suffer of a moment of subjectivity due to inter- and intra-individual variations. The aim of the present study was to assess, by computerized morphometry, the morphological features in benign and malignant adrenocortical neoplasms. Eleven adrenocortical adenomas (ACA) were compared with 18 adrenocortical cancers (ACC). All specimens were stained with H&E, cellular proliferation marker Ki-67 and reticulin. We generated a morphometric model based on the analysis of volume fractions occupied by Ki-67 positive and negative cells (nuclei and cytoplasm), vascular and inflammatory compartment; we also analyzed the surface fraction occupied by reticulin. We compared the quantitative data of Ki-67 obtained by morphometry with the quantification resulting from pathologist's visual reading. The volume fraction of Ki-67 positive cells in ACCs was higher than in ACAs. The volume fraction of nuclei in unit volume and the nuclear/cytoplasmic ratio in both Ki-67 negative cells and Ki-67 positive cells were prominent in ACCs. The surface fraction of reticulin was considerably lower in ACCs. Our computerized morphometric model is simple, reproducible and can be used by the pathologist in the histological workup of adrenocortical tumors to achieve precise and reader-independent quantification of several morphological characteristics of adrenocortical tumors.
良性及单纯局限性恶性肾上腺皮质病变的诊断仍是一个复杂的问题。此外,基于组织学的诊断可能会因个体间和个体内的差异而存在一定主观性。本研究的目的是通过计算机形态测量法评估良性和恶性肾上腺皮质肿瘤的形态学特征。将11例肾上腺皮质腺瘤(ACA)与18例肾上腺皮质癌(ACC)进行比较。所有标本均用苏木精-伊红染色、细胞增殖标志物Ki-67和网状纤维染色。我们基于对Ki-67阳性和阴性细胞(细胞核和细胞质)、血管和炎症区域所占体积分数的分析建立了一个形态测量模型;我们还分析了网状纤维所占的表面分数。我们将通过形态测量法获得的Ki-67定量数据与病理学家视觉读数得出的定量结果进行比较。ACC中Ki-67阳性细胞的体积分数高于ACA。在ACC中,单位体积内细胞核的体积分数以及Ki-67阴性细胞和Ki-67阳性细胞中的核/质比均较为突出。ACC中网状纤维的表面分数明显较低。我们的计算机形态测量模型简单、可重复,病理学家可在肾上腺皮质肿瘤的组织学检查中使用该模型,以实现对肾上腺皮质肿瘤多种形态学特征的精确且与阅片者无关的定量分析。