Cell atypia profiles for bronchial epithelial cells: mathematical evaluation of sputum cellular atypia in squamous cell carcinogenesis of the lung.

Atypical bronchial epithelial cells from the sputum of male cigarette smokers were digitized by scanning microphotometry and analyzed by computerized image analysis techniques. A set of specific analytic features based on cell morphology was extracted and combined mathematically to be expressed as a single number (Atypia Status Index). This index represented the stages of the cellular atypia (squamous metaplasia; mild, moderate or severe atypia; or carcinoma) quantiatively as a single number varying between 0.0 and 5.5 The Atypia Status Index for each cell correlated highly (94% to 99%) with visual cytopathologic classification. The distributions of cells according to their indices were profiled for patients at various stages of carcinogenesis and used to classify patients relative to their degree of cell atypia. These results compared favorable to those of the clinical evaluation.