Dardick I, Butler E B, Dardick A M
Acta Cytol. 1986 Jul-Aug;30(4):379-84.
Various approaches, including morphometric image analysis, are currently being used to improve the distinction between diffuse mesothelioma and metastatic adenocarcinoma of the serous membranes. Since exfoliated cells of malignant mesotheliomas were thought to have nuclear profile contours with greater irregularity than the similar profiles in metastatic adenocarcinoma cells in pleural effusions, this and other nuclear parameters were measured in ultrastructurally examined preparations from three cases of reactive mesothelial hyperplasia, seven examples of diffuse mesothelioma and three cases of metastatic adenocarcinoma (with primaries in the ovary, esophagus and prostate). Contrary to the subjective impression, the nuclei in metastatic adenocarcinomas actually had a mean nuclear contour index greater than that found in diffuse mesotheliomas; statistically, the difference was not significant. Likewise, such other nuclear parameters as nuclear area, condensed chromatin area and contour index, percentage of condensed chromatin and number of condensed chromatin clumps per nuclear profile did not discriminate between malignant mesotheliomas and adenocarcinomas metastatic to pleural surfaces. These morphometric results quantitate the similarities in nuclear size, nuclear shape and condensed chromatin arrangement in these two types of tumor and explain why the cytopathologist has such great difficulty in distinguishing between exfoliated mesothelioma and adenocarcinoma cells in most cases.
目前正在采用包括形态计量图像分析在内的各种方法，以提高弥漫性间皮瘤与浆膜转移性腺癌之间的鉴别能力。由于恶性间皮瘤的脱落细胞被认为其核轮廓比胸腔积液中转移性腺癌细胞的类似轮廓具有更大的不规则性，因此在超微结构检查的标本中测量了三例反应性间皮增生、七例弥漫性间皮瘤和三例转移性腺癌（原发部位分别为卵巢、食管和前列腺）的这一参数以及其他核参数。与主观印象相反，转移性腺癌中的细胞核实际上平均核轮廓指数高于弥漫性间皮瘤；从统计学上看，差异不显著。同样，其他核参数，如核面积、凝聚染色质面积和轮廓指数、凝聚染色质百分比以及每个核轮廓的凝聚染色质团块数量，也无法区分恶性间皮瘤和胸膜表面转移性腺癌。这些形态计量学结果量化了这两种肿瘤在核大小、核形状和凝聚染色质排列方面的相似性，并解释了为什么细胞病理学家在大多数情况下难以区分脱落的间皮瘤细胞和腺癌细胞。
