子宫内膜增生过长与内膜腺癌细胞核形态及DNA图像定量研究

Nuclear morphometry and DNA image analyses of endometrial hyperplasias and adenocarcinoma

目的 探讨子宫内膜增生过长与子宫内膜腺癌细胞核形态和DNA含量的变化规律。方法 应用计算机图像分析系统测定正常增生晚期子宫内膜 ,子宫内膜增生过长单纯型、囊腺型、腺瘤型、不典型增生和子宫内膜腺癌的细胞核形态和DNA含量参数 ,共 12 1例。结果 不典型增生组的细胞核面积 (AREA)、核长径(DMAX)、核短径 (DMIX)、核周长 (PERIM)的测量值均小于内膜腺癌组 (P <0 0 0 1) ;核形状因子 (FSHAPE)与腺瘤型组的差异有显著统计学意义 (P <0 .0 0 1) ,与内膜癌组的差异无统计学意义 (P >0 .0 5 )。 3 3 .3 %的不典型增生 5cER >10 %。结论 子宫内膜细胞核形态和DNA含量的图像定量分析能以量化方式反映子宫内膜增生过长与内膜腺癌之间的关系。子宫内膜不典型增生是界于良恶性子宫内膜疾病之间的“界限性”

Objective To investigate the dynamic change of the nuclear morphometry and DNA content in endometrial hyperplasia (EH) and endometrial adenocarcinoma (EA). Methods\ The morphological parameters including AREA, DMAX, DMIX, PERIM, FSHAPE and DNA contents were measured in 121 cases of normal proliferation, EH, and EA by using computerized image analysis system. Results\ AREA, DMAX, DMIX, and PERIM value in atypical EH was less than those in EA group ( P <0 001); For FSHAPE, there was a significant difference between atypical EH and adenomatous EH ( P <0.001), while no significant difference was found between atypical EH and EA ( P >0 05). 33 3% atypical EH was found to have a 5cER value greater than 10%. Conclusion The nuclear morphometry and DNA content image analysis help to differentiate EH from EA quantitively. Atypical EH may be a 'borderline change” between benign and malignant lesions of endometrium.