Department of Gynecology-Oncology, Rambam Health Care Campus, Haifa, Israel.
Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Microsc Res Tech. 2021 Nov;84(11):2559-2564. doi: 10.1002/jemt.23805. Epub 2021 Apr 30.
Urothelial carcinoma is the ninth most common cancer in the world. Cytological analysis of the urine is used for screening, as well as for cases suspected for neoplasia of the urinary tract. However, the sensitivity of urine cytology examination is low. The golden standard for diagnosing bladder cancer relies upon cystoscopy followed by a biopsy, which is microscopically assessed by the pathologist. Treatment decisions are based on the histological grade and stage of the tumor. Posttreatment tumor recurrence is 50%. The purpose of this study is to predict recurrence of urothelial carcinoma using a novel morphometric method of nuclear symmetry analysis. This method may help tailor the appropriate treatment and may reduce the need of invasive surgical procedures in patients. Computerized morphometry was applied to develop multiple symmetry indices of the nuclei of the tumor cells as follows: each nucleus was physically divided along its digital axis in two segments that were separately analyzed for their shape, size, optical density, and texture. Subsequently, ratios were obtained by mathematically dividing between the morphometric values of the two nuclear segments where the denominator contained the largest value of the two. These ratios were named symmetry indices and were included as variables to predict the recurrence time of the tumors. The change in the symmetry indices (loss of symmetry) of the nuclear roundness, fractal dimension and margination were the only independent predictors of recurrence time. Computerized morphometry of nuclear symmetry indices may help to predict tumor recurrence in urothelial carcinomas.
膀胱癌是全球第 9 常见的癌症。尿液细胞学分析用于筛查，也用于怀疑尿路肿瘤的病例。然而，尿液细胞学检查的敏感性较低。诊断膀胱癌的金标准依赖于膀胱镜检查，随后进行活检，由病理学家进行显微镜评估。治疗决策基于肿瘤的组织学分级和分期。治疗后肿瘤复发率为 50%。本研究旨在使用核对称分析的新形态计量学方法预测尿路上皮癌的复发。这种方法可能有助于制定适当的治疗方案，并可能减少患者对侵入性手术的需求。计算机形态计量学被应用于开发肿瘤细胞核的多个对称指数，方法如下：每个细胞核沿其数字轴物理地分为两个部分，分别对其形状、大小、光密度和纹理进行分析。随后，通过数学方法将两个核段的形态计量值相除，分子为较小的值，分母为较大的值，得到比值。这些比值被命名为对称指数，并作为变量纳入预测肿瘤复发时间。核圆形度、分形维数和边缘化的对称性指数的变化是预测复发时间的唯一独立预测因子。核对称性指数的计算机形态计量学可能有助于预测尿路上皮癌的肿瘤复发。
