Yoshioka Haruhiko, Shimoda Tsubasa, Oikawa Sota, Morohashi Satoko, Hasegawa Yoshie, Horie Kayo, Watanabe Jun
Hirosaki University Graduate School of Health Sciences, Department of Bioscience and Laboratory Medicine, Hirosaki, Japan.
Department of Clinical Laboratory, Hirosaki Municipal Hospital, Hirosaki, Japan.
Acta Cytol. 2022;66(2):149-158. doi: 10.1159/000519490. Epub 2021 Oct 28.
Recent advances in high-precision mammography and ultrasound screening have led to an increase in the detection of early lesions (ductal carcinoma in situ and small cancers) appearing as microcalcified lesions or microcystic images, and there needs to be an improvement in the accuracy of breast fine-needle aspiration biopsy (FNAB) assessing these lesions. The objective of this study was to investigate whether fractal analysis of Kirsch edge images for the tissue fragment inner structure (FKT) is useful in breast FNAB. FKT measures tissue fragment chromasia of hyperchromatic crowded tissue fragments (HCG), tissue fragment shape unevenness, and tissue fragment inner structure complexity. Study Design Materials: Nineteen epithelial tissue fragments of fibroadenoma (FA) from 7 patients and 52 tissue fragments of invasive breast carcinoma of no special type (IBC-NST) (grade 1-2) from 11 patients were assessed. First, tissue fragments were classified into small (smaller than 60 × 102 μm2), medium, and large (100 × 102 μm2 or larger), and the appearance rate of each size was determined. Second, for FKT, the luminance value of tissue fragment chromasia, the unevenness and fractal value, and the tissue fragment inner structure complexity were determined. In statistical analysis, the Steel-Dwass test, nonlinear discriminant analysis, and receiver operating characteristic analysis were performed, setting the significance level at p < 0.05.
"Unevenness of the tissue fragment shape," "fractal value of the tissue fragment shape," and "fractal value of the tissue fragment inner structure" were significantly higher in small and large tissue fragments in IBC-NST compared with those in FA. The specificity and sensitivity were the highest (100%) in small tissue fragments in multivariate analysis using 4 variables ("luminance value of tissue fragment chromasia," "unevenness of tissue fragment shape," "fractal value of the tissue fragment shape," and "fractal value of the tissue fragment inner structure").
FKT, which evaluates "tissue fragment darkness," "tissue fragment shape unevenness," and "tissue fragment inner structure complexity" focusing on small tissue fragments of HCG in breast FNAB, is useful as a system that assists cytopathological assessment of breast FNAB.
高精度乳腺钼靶摄影和超声筛查的最新进展使得作为微钙化病变或微囊图像出现的早期病变（导管原位癌和小癌）的检出率有所增加，而乳腺细针穿刺活检（FNAB）评估这些病变的准确性需要提高。本研究的目的是调查用于组织碎片内部结构的基尔希边缘图像的分形分析（FKT）在乳腺FNAB中是否有用。FKT测量组织碎片的染色质（高染色质密集组织碎片，HCG）、组织碎片形状不均匀性以及组织碎片内部结构复杂性。研究设计材料：评估了来自7例患者的19个纤维腺瘤（FA）上皮组织碎片以及来自11例患者的52个非特殊类型浸润性乳腺癌（IBC-NST，1-2级）组织碎片。首先，将组织碎片分为小（小于60×102μm2）、中、大（100×102μm2或更大），并确定每种大小的出现率。其次，对于FKT，确定组织碎片染色质的亮度值、不均匀性和分形值以及组织碎片内部结构复杂性。在统计分析中，进行Steel-Dwass检验、非线性判别分析和受试者工作特征分析，将显著性水平设定为p < 0.05。
与FA相比，IBC-NST中小和大组织碎片的“组织碎片形状不均匀性”、“组织碎片形状分形值”和“组织碎片内部结构分形值”显著更高。在使用4个变量（“组织碎片染色质亮度值”、“组织碎片形状不均匀性”、“组织碎片形状分形值”和“组织碎片内部结构分形值”）的多变量分析中，小组织碎片的特异性和敏感性最高（100%）。
FKT在乳腺FNAB中侧重于评估HCG的小组织碎片，可评估“组织碎片暗度”、“组织碎片形状不均匀性”和“组织碎片内部结构复杂性”，作为辅助乳腺FNAB细胞病理学评估的系统很有用。
