Mattfeldt T, Schürmann G, Feichter G
Virchows Arch A Pathol Anat Histopathol. 1987;410(5):433-41. doi: 10.1007/BF00712763.
A retrospective analysis of surgically resected thyroid nodules by stereology and DNA flow cytometry was performed in 15 follicular adenomas and 15 well-differentiated follicular carcinomas. The criteria for diagnosis were based on the WHO classification of thyroid tumours. By area-weighted random sampling of the visual fields for light-microscopic stereology, any subjective selection bias was precluded, and each point within the embedded neoplastic tissue was given equal probability of being analyzed. 150-250 tumour cell nucleus (TCN) profiles were studied per case by a semiautomatic image analyzing system. Flow cytometric analyses included measurement of the DNA-index, and the percentages of cells in S-phase and in G2/M-phase. Adenomas and carcinomas did not differ in stereological estimates related to TCN size. As examination of the stereological techniques by nested analysis of variance showed that this result cannot be ascribed to inaccurate methods, it follows that determination of TCN size is not a useful tool for the diagnosis of malignancy in well-differentiated thyroid tumours. Both groups included similar proportions of diploid and aneuploid neoplasms. In the carcinoma group the percentage of tumour cells in the G2/M-phase was more than twice as high than in the adenoma group (P less than 0.01). The ratio of short to long TCN profile axis was significantly smaller, and the coefficient of variation of TCN profile area was significantly higher in carcinomas than in adenomas. These findings are consistent with more unequiaxed TCN and higher anisokaryosis in the malignant tumours. Despite the significant differences, however, overlap of data from individual cases precludes the use of these estimates as diagnostic criteria. Pooling of the follicular tumours and dichotomizing the sample by the DNA-index showed that mean TCN profile area is increased and surface-to-volume ratio of TCN is decreased in aneuploid as compared to diploid tumours. This finding indicates that aneuploidy is associated with an increase of TCN size.
对15例滤泡性腺瘤和15例高分化滤泡癌进行了手术切除的甲状腺结节的体视学和DNA流式细胞术回顾性分析。诊断标准基于世界卫生组织甲状腺肿瘤分类。通过光镜体视学视野的面积加权随机抽样，排除了任何主观选择偏倚，包埋肿瘤组织内的每个点被分析的概率相等。每例通过半自动图像分析系统研究150 - 250个肿瘤细胞核（TCN）轮廓。流式细胞术分析包括DNA指数测量以及S期和G2/M期细胞百分比测量。腺瘤和癌在与TCN大小相关的体视学估计上没有差异。通过方差分析的嵌套分析对体视学技术进行检验表明，该结果不能归因于不准确的方法，因此可以得出结论，TCN大小的测定不是诊断高分化甲状腺肿瘤恶性程度的有用工具。两组中二倍体和非整倍体肿瘤的比例相似。在癌组中，G2/M期肿瘤细胞百分比比腺瘤组高出两倍多（P小于0.01）。癌组中TCN轮廓短轴与长轴之比明显更小，TCN轮廓面积的变异系数明显高于腺瘤组。这些发现与恶性肿瘤中更多的不等轴TCN和更高的核异形性一致。然而，尽管存在显著差异，但个别病例数据的重叠使得这些估计不能用作诊断标准。将滤泡性肿瘤合并并按DNA指数对样本进行二分法分析表明，与二倍体肿瘤相比，非整倍体肿瘤的平均TCN轮廓面积增加，TCN的表面积与体积比降低。这一发现表明非整倍体与TCN大小增加有关。
