卵巢交界性粘液性囊腺瘤与高分化粘液性囊腺癌定量病理学研究

Differential diagnosis of borderline and well-differentiated mucinous cystadenocarcinomas of the ovary by quantitative nuclear morphology

目的 探讨定量病理学在妇科粘液性肿瘤中的诊断意义。方法 采用图像分析进行细胞核形态定量分析 ,并建立分类函数。结果 核体密度、核偏度、积分光密度、AgNORs颗粒计数和核面积是交界性粘液囊腺瘤和高分化粘液性癌鉴别的有效指标。在回顾性考核中 ,判别前者的敏感性和特异性分别为 95%和 1 0 0 % ;后者的敏感性和特异性分别为 1 0 0 %和 95% ,总错误率为 2 %。在前瞻性考核中 ,判别前者的敏感性和特异性分别为 86%和 91 % ;后者的敏感性和特异性分别为 91 %和 86% ,总错误率为 1 1 %。结论 细胞核定量病理学在此两种疾病的鉴别诊断上具有实用价值。

Objective To investigate the diagnostic value of quantitative nuclear morphology in ovarian tumors.Methods Multiple descriptons extracted from nuclear tracing and intranuclear gray-level analysis of argyrophilic nucleolar organizer regions (AgNORs) were quantitatively evaluated in 21 borderline and 27 well-differentiated nucinous cystadenocarcinomas by image analysis technology.Results The parameters of nuclear area,integrated optical density and AgNORs number and histological structure (LPP and Vv)were significantly different between the diseases,and used to develop a classification function.In the development set,these 2 discriminant functions demonstrated respective sensitivity and specificity of 95% and 100% for borderline,100% and 95% for well-differentiated nucinous cystadenocarcinomas.In the test set,the sensitivity and specificity were 86% and 91% for borderline,91% and 86% for well nucinous cystadenocarcinomas.Sum of error rate was only 2% in retrospective validation,but 11% in prospective validation.Conclusions Quantitative nuclear morphology may be useful in discriminating between these tumors.