Department of Surgery, Kyorin University School of Medicine, Tokyo, Japan.
Department of Pathology, Kyorin University School of Medicine, Tokyo, Japan.
Diagn Cytopathol. 2022 Aug;50(8):394-403. doi: 10.1002/dc.24978. Epub 2022 May 14.
The histological classifications of invasive lung adenocarcinoma subtypes are considered to predict patient prognosis after surgical treatment. The objectives of this study were to evaluate cytomorphological characteristics and proliferative activities among the histological predominant patterns by performing cytomorphometric and flow cytometric analyses using liquid-based cytology materials.
Cytological samples fixed by liquid-based cytology preservatives from 53 surgically-resected lung adenocarcinoma specimens were obtained between August 2018 and November 2019. The Papanicolaou-stained and paired Ki-67-stained slides were analyzed for calculating nuclear morphology (nuclear area, nuclear perimeter and nuclear circularity) and Ki-67 labeling index using software. The cell proliferation index (CPIx) was calculated and cellular information including cell cycle stage of tumor cells was obtained by flow cytometry.
The 53 cases included papillary (n = 29), acinar (n = 8), lepidic (n = 5), and solid (n = 4) subtypes, and invasive mucinous adenocarcinoma (n = 7) were also included. In the lepidic pattern, nuclear area (79.6 ± 28.8 μm ) and perimeter (34.1 ± 6.1 μm) were relatively larger and longer than those of the other predominant patterns. The Ki-67 labeling index of the solid pattern (27.9 ± 12.5%) was highest compared with those of other predominant patterns. There were statistically significant differences in the lepidic versus solid patterns and the papillary versus solid patterns (p = .013 and p = .039, respectively). The calculated mean CPIx of the lepidic and the acinar patterns were approximately two-fold higher than those of the other predominant patterns.
By revealing the differences of cytomorphological characteristics, these methodologies might be used for diagnosing cytopathological materials using digital cytopathology.
浸润性肺腺癌亚型的组织学分类被认为可以预测手术治疗后患者的预后。本研究的目的是通过使用液基细胞学材料进行细胞形态计量学和流式细胞术分析，评估组织学主要模式的细胞形态特征和增殖活性。
2018 年 8 月至 2019 年 11 月期间，从 53 例手术切除的肺腺癌标本中获得了用液基细胞学防腐剂固定的细胞学样本。对巴氏染色和配对 Ki-67 染色的载玻片进行分析，使用软件计算核形态（核面积、核周长和核圆形度）和 Ki-67 标记指数。通过流式细胞术计算细胞增殖指数（CPIx）并获得肿瘤细胞的细胞周期阶段等细胞信息。
53 例包括乳头型（n=29）、腺泡型（n=8）、贴壁型（n=5）和实体型（n=4），还包括浸润性黏液腺癌（n=7）。贴壁型的核面积（79.6±28.8μm）和周长（34.1±6.1μm）相对较大和较长，与其他主要模式相比。实体型的 Ki-67 标记指数（27.9±12.5%）最高，与其他主要模式相比有统计学差异（p=0.013 和 p=0.039）。贴壁型与实体型之间以及乳头型与实体型之间存在统计学差异（p=0.013 和 p=0.039）。贴壁型和腺泡型的计算平均 CPIx 约为其他主要模式的两倍。
通过揭示细胞形态特征的差异，这些方法可能用于使用数字细胞学诊断细胞学材料。
