形态计量学方法在观察硬腭部粘膜癌前病变及癌变中的意义

THE SIGNIFICANCE OF MORPHOMETRY IN ESTIMATING THE PREMALIGNANT AND MALIGNANT LESIONS OF HUMAN HARD PAMTE

本文报道运用形态计量学方法对硬腭部正常粘膜、慢性非特异性炎症、单纯性过角化、乳头状瘤、癌旁上皮、鳞癌癌巢上皮的上皮组织基底层和棘层的细胞和胞核的体积、直径及Ｎ／Ｃ比值进行了系统观察。观察结果表明，不论是在基底层还是在棘层，其细胞和胞核的体积（Ｖ）、直径（Ｄ）这些反映胞体和胞核大小的指标均以正常组最小而癌巢上皮最大，其次是癌旁上皮组。此外发现，基底层细胞及胞核的形态大小参数最能反映病变的程度，由正常经癌前到癌变，其Ｖ、Ｄ值呈现出逐渐增大的趋势，癌巢组及癌旁上皮组与其它组比较有一定的统计学意义。作者还发现，Ｎ／ｃ比值对于判断癌前病变和癌变程度没有太大的参考价值。本文结果预示，用形态计量学方法通过反映细胞和胞核大小的定量指标可以较为准确的反映病变的状态，对于判断口腔粘膜癌前病变及癌变具有重要的参考价值。

Nuclear and cellilar volume(v), nuclear diameter(D) and N/C ratio were analysed using morphometric methods with a VIDAS image analysing system in basal(B)and spinous(S)cell layers derived from the epithelium immediately adja-cent to squamous cell carcinoma(EAC) and the islands of carcinomatous epithelium(CI) of the human hard palarte. Normal epithelium (N), squamous cell papilloma(pp). hyperkeratosis(HK) and non-specific chronic inflammation (IF) were used as controls.the results showed that the dimensions of volume and diameter in both B and S layers were lowest in the N group and highest in CI group, the EAC group is on thesecond rank, Significant progressive increases in the dimensions of both the cell andnucleus of the B cells were detected from N through benign and EAC to CI.Parame-ters for S cells showed similar trend to those of the basal layer, although they werenot as consistent, but the values were still hihger in EAC and CI than those in otherconditions.N/C ratio did not appear to discriminate between the premalignant andmalignant lesions. We conclude that moephometry has the ability to disciriminate nor-mal and other benign lesions from high risk premalignant (EAC) and malignant lesi-ons(CI). The methods require more comprehensive assessment as possible diagnosticdescriptors for distinguishing between premalignant and benign oral mucosa lesions.