子宫内膜液基细胞学制备中子宫内膜样癌 Grade1、Grade3 和浆液性腺癌的形态学差异。

Morphometrical Differences among Endometrial Endometrioid Carcinoma Grade 1, Grade 3, and Serous Carcinoma in Endometrial Liquid-Based Cytology Preparations.

机构信息

Department of Bioscience and Laboratory Medicine, Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan.

Anatomic Pathology Laboratory, Hirosaki University Hospital, Hirosaki, Japan.

出版信息

Acta Cytol. 2022;66(6):524-531. doi: 10.1159/000525948. Epub 2022 Sep 12.

DOI:10.1159/000525948

PMID:36096095

Abstract

INTRODUCTION

In Japan, the direct smearing preparation (conventional preparation) has been widely used for cytological examination of the endometrium. Problems with the conventional preparation can be dissolved by liquid-based cytology (LBC) preparation. The Yokohama System is a method for reporting endometrial cytology, but the system lumps cancers together and does not distinguish between histological types. The objective of this study was to clarify morphometrical differences among endometrial endometrioid carcinoma grade 1 (G1), grade 3 (G3), and serous carcinoma (Serous) by image analysis of endometrial LBC.

METHODS

Using Papanicolaou smears prepared by LBC after sampling with a brush from 32 G1, 16 G3, and 16 Serous patients, image analysis was performed concerning the following 11 items: (1) number of layers of cluster, (2) area of cluster, (3) perimeter of cluster, (4) roundness of cluster, (5) complexity of cluster, (6) area of nucleus, (7) perimeter of nucleus, (8) roundness of nucleus, (9) complexity of nucleus, (10) area of nucleolus, and (11) nucleolus/nucleus (N/N) ratio. The data were statistically compared among G1, G3, and Serous.

RESULTS

Significant differences were observed in the number of layers of cluster (G1<G3<Serous), area of cluster (G1>G3<Serous), area of nucleus (G1<G3<Serous), area of nucleolus (G1<G3<Serous), roundness of cluster (G1>G3, G1>Serous), complexity of cluster (G1<G3, G1<Serous), roundness of nucleus (G1<Serous), complexity of nucleus (G1>Serous), and N/N ratio (G1>G3, G3<Serous).

CONCLUSION

The number of layers and area of cluster, complexity of cluster, area and complexity of nucleus, area of nucleolus, and N/N ratio were suggested to be useful for the differentiation of histological types among G1, G3, and Serous. Particularly, differences in the number of layers of cluster, size of nucleus, and size of nucleolus among histological types were large and are considered to be potentially effective points of differential diagnosis.

摘要

介绍

在日本，直接涂片制备（常规制备）已广泛用于子宫内膜细胞学检查。常规制备中出现的问题可以通过液基细胞学（LBC）制备来解决。横滨系统是一种子宫内膜细胞学报告系统，但该系统将癌症归为一类，不区分组织学类型。本研究的目的是通过对子宫内膜 LBC 的图像分析，阐明子宫内膜样癌 1 级（G1）、3 级（G3）和浆液性癌（Serous）之间的形态学差异。

方法

使用毛刷取样后通过 LBC 制备巴氏涂片，对 32 例 G1、16 例 G3 和 16 例 Serous 患者进行图像分析，针对以下 11 项进行分析：（1）细胞团的层数；（2）细胞团的面积；（3）细胞团的周长；（4）细胞团的圆度；（5）细胞团的复杂度；（6）细胞核的面积；（7）细胞核的周长；（8）细胞核的圆度；（9）细胞核的复杂度；（10）核仁的面积；（11）核仁/细胞核（N/N）比值。对 G1、G3 和 Serous 组的数据进行统计学比较。

结果

细胞团的层数（G1<G3<Serous）、细胞团的面积（G1>G3<Serous）、细胞核的面积（G1<G3<Serous）、核仁的面积（G1<G3<Serous）、细胞团的圆度（G1>G3，G1>Serous）、细胞团的复杂度（G1<G3，G1<Serous）、细胞核的圆度（G1<Serous）、细胞核的复杂度（G1>Serous）和 N/N 比值（G1>G3，G3<Serous）存在显著差异。