Binder M, Steiner A, Mossbacher U, Hunegnaw M, Pehamberger H, Wolff K
Department of Dermatology, University of Vienna Medical School, Austria.
Am J Dermatopathol. 1998 Oct;20(5):453-8. doi: 10.1097/00000372-199810000-00004.
Keratoacanthoma (KA) is a fairly common neoplasm that in the past has been considered by many to be benign. Keratoacanthoma is usually differentiated from squamous cell carcinoma (SCC) by histopathologic criteria. However, the cytologic features of KA and SCC are often similar. Hence, KA may be confused with SCC at the histopathologic level. Volume-weighted mean nuclear volume (Vv) is determined by a technique that permits an unbiased and efficient estimation of nuclear volumes in tissues without any assumptions regarding nuclear shape. In this study, the volume-weighted mean nuclear volume was determined in 18 KAs and 19 SCCs to investigate whether this stereologic approach may be of use in the differentiation of these two tumors. Vv was determined by computer-assisted image analysis (IBAS 20, Kontron, Germany) on Feulgen-stained sections employing stereologic estimation of the volume-weighted mean nuclear volume. The mean Vv of KA was 704.5 microm3 (SD +/-170.5), whereas SCC exhibited a significantly lower Vv of 533.9 microm3 (SD+/-164.9) (p = 0.006). The sensitivity and specificity of Vv for the discrimination between KA and SCC was 0.80 and 0.78, respectively. We found that KAs show a significantly larger Vv than SCCs and thus, the estimation of the volume-weighted mean nuclear volume may be regarded as a helpful tool for the differential diagnosis of KA and SCC.
角化棘皮瘤（KA）是一种相当常见的肿瘤，过去许多人认为它是良性的。角化棘皮瘤通常通过组织病理学标准与鳞状细胞癌（SCC）相鉴别。然而，KA和SCC的细胞学特征往往相似。因此，在组织病理学水平上，KA可能会与SCC混淆。体积加权平均核体积（Vv）是通过一种技术测定的，该技术可以在不考虑核形状的任何假设的情况下，对组织中的核体积进行无偏且有效的估计。在本研究中，测定了18例KA和19例SCC的体积加权平均核体积，以研究这种体视学方法是否可用于这两种肿瘤的鉴别。Vv通过计算机辅助图像分析（IBAS 20，德国康创公司）在福尔根染色切片上采用体积加权平均核体积的体视学估计来测定。KA的平均Vv为704.5立方微米（标准差±170.5），而SCC的Vv显著较低，为533.9立方微米（标准差±164.9）（p = 0.006）。Vv区分KA和SCC的敏感性和特异性分别为0.80和0.78。我们发现KA的Vv明显大于SCC，因此，体积加权平均核体积的估计可被视为鉴别KA和SCC的有用工具。
