Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20133 Milan, Italy.
Department of Diagnosis and Surgery, Division of Periodontics, School of Dentistry, Sao Paulo State University (UNESP), Aracatuba 16015-050, SP, Brazil.
Medicina (Kaunas). 2022 Jun 29;58(7):867. doi: 10.3390/medicina58070867.
: In dentistry, the assessment of the histomorphometric features of periodontal (PD) and peri-implant (PI) lesions is important to evaluate their underlying pathogenic mechanism. The present study aimed to compare manual and digital methods of analysis in the evaluation of the inflammatory biomarkers in PI and PD lesions. : PD and PI inflamed soft tissues were excised and processed for histological and immunohistochemical analyses for CD3+, CD4+, CD8+, CD15+, CD20+, CD68+, and CD138+. The obtained slides were acquired using a digital scanner. For each marker, 4 pictures per sample were extracted and the area fraction of the stained tissue was computed both manually using a 594-point counting grid (MC) and digitally using a dedicated image analysis software (DC). To assess the concordance between MC and DC, two blinded observers analysed a total of 200 pictures either with good quality of staining or with non-specific background noise. The inter and intraobserver concordance was evaluated using the intraclass coefficient and the agreement between MC and DC was assessed using the Bland-Altman plot. The time spent analysing each picture using the two methodologies by both observers was recorded. Further, the amount of each marker was compared between PI and PD with both methodologies. The inter- and intraobserver concordance was excellent, except for images with background noise analysed using DC. MC and DC showed a satisfying concordance. DC was performed in half the time compared to MC. The morphological analysis showed a larger inflammatory infiltrate in PI than PD lesions. The comparison between PI and PD showed differences for CD68+ and CD138+ expression. DC could be used as a reliable and time-saving procedure for the immunohistochemical analysis of PD and PI soft tissues. When non-specific background noise is present, the experience of the pathologist may be still required.
在牙科中，评估牙周（PD）和种植体周围（PI）病变的组织形态计量学特征对于评估其潜在的发病机制非常重要。本研究旨在比较手动和数字分析方法在评估 PI 和 PD 病变中炎症生物标志物的应用。 PD 和 PI 炎性软组织被切除并进行组织学和免疫组织化学分析，用于检测 CD3+、CD4+、CD8+、CD15+、CD20+、CD68+和 CD138+。获得的切片使用数字扫描仪采集。对于每个标志物，从每个样本中提取 4 张图片，并使用 594 点计数网格（MC）手动计算和使用专用图像分析软件（DC）计算染色组织的面积分数。为了评估 MC 和 DC 之间的一致性，两名观察者总共分析了 200 张具有良好染色质量或非特异性背景噪声的图片。使用组内相关系数评估观察者内和观察者间的一致性，使用 Bland-Altman 图评估 MC 和 DC 之间的一致性。记录两名观察者使用两种方法分析每张图片所花费的时间。此外，使用两种方法比较 PI 和 PD 之间每个标志物的量。 观察者内和观察者间的一致性除了使用 DC 分析具有背景噪声的图像外，均为优秀。 MC 和 DC 显示出令人满意的一致性。与 MC 相比，DC 耗时更短。形态学分析显示 PI 病变的炎症浸润比 PD 病变更广泛。 PI 和 PD 之间的比较显示 CD68+和 CD138+表达存在差异。 DC 可作为一种可靠且省时的 PD 和 PI 软组织免疫组织化学分析方法。当存在非特异性背景噪声时，可能仍然需要病理学家的经验。
