Onuma Toshimichi, Shinagawa Akiko, Kurokawa Tetsuji, Orisaka Makoto, Yoshida Yoshio
Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan.
Department of Obstetrics and Gynecology, Fukui-ken Saiseikai Hospital, Fukui 918-8503, Japan.
Cancers (Basel). 2024 Jul 6;16(13):2469. doi: 10.3390/cancers16132469.
Endometrial cancer (EC) in women is increasing globally, necessitating improved diagnostic methods and prognosis prediction. While endometrial histology is the conventional approach, liquid-based endometrial cytology may benefit from novel analytical techniques for cell clusters. A clinical study was conducted at the University of Fukui Hospital from 2012 to 2018, involving 210 patients with endometrial cytology. The liquid-based cytology images were analyzed using cell cluster analysis with Image J software. Logistic regression, ROC analysis, and survival analysis were employed to assess the diagnostic accuracy and prognosis between cell cluster analysis and EC/atypical endometrial hyperplasia (AEH). Circularity and fractal dimension demonstrated significant associations with EC and AEH, regardless of age and cytology results. The ROC analysis revealed improved diagnostic accuracy when combining fractal dimension with cytology, particularly in menopausal age groups. Lower circularity and solidity were independently associated with poor overall survival, while higher fractal dimension values correlated with poorer overall survival in Grades 2 and 3 endometrial cancers. The combination of circularity and fractal dimension with cytology improved diagnostic accuracy for both EC and AEH. Moreover, circularity, solidity, and fractal dimension may serve as prognostic indicators for endometrial cancer, contributing to the development of more refined screening and diagnostic strategies.
全球范围内，女性子宫内膜癌（EC）的发病率正在上升，因此需要改进诊断方法和预后预测。虽然子宫内膜组织学是传统方法，但基于液体的子宫内膜细胞学可能受益于针对细胞簇的新型分析技术。2012年至2018年，在福井大学医院进行了一项临床研究，涉及210例子宫内膜细胞学患者。使用Image J软件通过细胞簇分析对基于液体的细胞学图像进行分析。采用逻辑回归、ROC分析和生存分析来评估细胞簇分析与EC/非典型子宫内膜增生（AEH）之间的诊断准确性和预后。无论年龄和细胞学结果如何，圆形度和分形维数均与EC和AEH存在显著关联。ROC分析表明，将分形维数与细胞学相结合时，诊断准确性有所提高，尤其是在绝经年龄组。较低的圆形度和紧实度与较差的总生存率独立相关，而在2级和3级子宫内膜癌中，较高的分形维数值与较差的总生存率相关。圆形度和分形维数与细胞学的结合提高了对EC和AEH的诊断准确性。此外，圆形度、紧实度和分形维数可作为子宫内膜癌的预后指标，有助于制定更精细的筛查和诊断策略。
