Morphometric markers for the evaluation of preneoplastic lesions in the lung. Diagnostic evaluation by high-resolution image analysis of atypical cells in sputum specimens.

A review is presented of the Baylor College of Medicine/NASA/Lyndon Johnson Space Center high-resolution image analysis system for the detection of preneoplastic lesions of the lung in sputum specimens. For each specimen, 200 cells are graded as to their Atypia Status Index (ASI), a numerical classification based on a weighted composite of morphometric markers identified in the digitized images. The ASI values, which place individual cells within categories ranging from squamous metaplastic to carcinomatous, form the basis of the Cell Atypia Profile (CAP), which reflects the overall status of the patient's bronchial epithelium and can be used to diagnose and monitor epithelial atypias. Initial studies have shown the ASI and CAP to be accurate indices, whose application in the studies of sputum of individuals at high risk for the development of lung cancer (cigarette smokers over 45 years of age and industrially exposed workers) could lead to the early detection of preneoplastic lung lesions and to effective early clinical intervention, including the cessation of smoking or the application of beta-carotone or retinoids, which reportedly arrest the progression of bronchial epithelial atypias. Computer-assisted cell image analysis of morphometric markers in cells in sputum specimens appears to be uniquely applicable for surveillance of individuals at risk for carcinoma of the lung.