Yeaton P, Kiss R, DePrez C, Salmon I, Pasteels J L, Jones R S, Frierson H F
Department of Internal Medicine, University of Virginia Health Sciences Center, Charlottesville, USA.
Mod Pathol. 1995 Oct;8(8):843-7.
Periampullary adenocarcinomas arise from pancreatic, biliary, or ampullary ductal epithelium. Their origin is difficult or impossible to discern by routine light microscopy of cytologic or small biopsy specimens. We used image analysis to describe the morphologic features of Feulgen-stained nuclei of biliary and ampullary adenocarcinomas and to compare these findings with those of pancreatic ductal adenocarcinomas. Surgically resected cases of ampullary adenocarcinoma (n = 7) and cholangiocarcinoma (n = 26) were selected on the basis of available formalin-fixed, paraffin-embedded tissue and diagnostic clinical data. Disaggregated nuclei were stained by the Feulgen reaction and analyzed using a digital image processor. Data from 15 morphonuclear parameters were assessed and compared with the results from the morphonuclear analysis of 22 pancreatic ductal adenocarcinomas. Multivariate analysis with canonical transformation of the data defined the ampullary adenocarcinomas and cholangiocarcinomas as occupying similar factorial distributions, whereas the pancreatic carcinomas were separate and distinct. Monovariate analysis identified seven parameters distinguishing pancreatic carcinoma from both ampullary carcinoma and cholangiocarcinoma, with P values < or = 0.001 and two others having P values < or = 0.01. Adenocarcinomas of ampullary or bile duct origin possess similar morphonuclear features described by image analysis. Image analysis provides a mechanism to discriminate adenocarcinomas arising from the bile ducts or ampulla from those arising in the pancreas.
壶腹周围腺癌起源于胰腺、胆管或壶腹导管上皮。通过对细胞学或小活检标本进行常规光学显微镜检查，很难或无法辨别其起源。我们使用图像分析来描述胆管癌和壶腹腺癌福尔根染色细胞核的形态特征，并将这些结果与胰腺导管腺癌的结果进行比较。根据现有的福尔马林固定、石蜡包埋组织和诊断临床数据，选择手术切除的壶腹腺癌病例（n = 7）和胆管癌病例（n = 26）。解离后的细胞核通过福尔根反应染色，并使用数字图像处理器进行分析。评估了15个形态核参数的数据，并与22例胰腺导管腺癌的形态核分析结果进行比较。对数据进行典型变换的多变量分析表明，壶腹腺癌和胆管癌占据相似的因子分布，而胰腺癌则是分开且不同的。单变量分析确定了7个参数可将胰腺癌与壶腹癌和胆管癌区分开来，P值≤0.001，另外2个参数的P值≤0.01。通过图像分析描述，壶腹或胆管起源的腺癌具有相似的形态核特征。图像分析提供了一种机制，可将胆管或壶腹起源的腺癌与胰腺起源的腺癌区分开来。
