Mohler J L, Partin A W, Lohr W D, Coffey D S
Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
J Urol. 1988 May;139(5):1080-4. doi: 10.1016/s0022-5347(17)42791-1.
Standard pathological grading systems for prostatic carcinoma based upon glandular architectural pattern or nuclear anaplasia have failed to predict the prognosis of individual patients. Quantitative morphometric analysis of nuclear shape has predicted the outcome of patients with prostatic carcinoma when evaluated by some but not all reported studies. Calculation of nuclear roundness factor by different investigators was complicated by equipment differences and lack of standardized methods for acquiring and reporting data. We have improved our system for nuclear contour digitization and determined its theoretical limitations by digitizing standardized objects. Measurement errors were independent of orientation or location of an object within a microscopic or digitizer tablet field, speed of digitization and introduction of a microscope extension tube and light emitting diode cursor. Perimeters and areas of circles and squares of actual or digitizer-projected diameter or sidelength greater than five mm. were measured with a reproducibility and accuracy of greater than or equal to 90%. When a microscopic circle of diameter similar to prostatic carcinoma nuclei was digitized at a magnification of 2580 X, perimeter and area measurements differed within or between observers by less than 5% and were more than 95% accurate. In order to calculate accurately and evaluate NRF for use in assessing the prognosis of patients with prostatic carcinoma investigators must precisely describe their digitization system, standardization method and observer reproducibility and accuracy when measuring circles that approximate the projected size of prostatic carcinoma nuclei.
基于腺管结构模式或核间变的前列腺癌标准病理分级系统未能预测个体患者的预后。当通过一些但并非所有已报道的研究进行评估时，核形状的定量形态计量分析已预测了前列腺癌患者的预后。不同研究者计算核圆度因子时，因设备差异以及缺乏获取和报告数据的标准化方法而变得复杂。我们改进了核轮廓数字化系统，并通过对标准化物体进行数字化来确定其理论局限性。测量误差与物体在显微镜或数字化仪平板视野内的方向或位置、数字化速度以及显微镜延长管和发光二极管光标的引入无关。对实际直径或数字化仪投影直径或边长大于5毫米的圆和正方形的周长和面积进行测量，其重现性和准确性大于或等于90%。当在2580倍放大倍数下对直径与前列腺癌细胞核相似的显微镜下的圆进行数字化时，观察者内部或之间的周长和面积测量差异小于5%，且准确性超过95%。为了准确计算并评估用于评估前列腺癌患者预后的核圆度因子，研究者在测量近似前列腺癌细胞核投影大小的圆时，必须精确描述其数字化系统、标准化方法以及观察者的重现性和准确性。
