Morphometric Analysis of Structural Atypism of Adenoma and Carcinoma of the Large Intestine with Special Reference to Borderline Lesion between Benignancy and Malignancy S. Togo 1 , K. Nakamura 1 1Department of Pathology, Institute of Basic Medical Sciences, The University of Tsukuba pp.423-432
Published Date 1983/4/25
DOI https://doi.org/10.11477/mf.1403109379
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 The purpose of the present paper is to analyz morphornetrically the structural atypism of benign adenomas and carcinomas of the large intestine, that is to say two-dimensionally and three-dimensionally, and to divide the borderline lesions into benign adenomas and carcinomas from the view-point of structural atypism.

 One hundred and forty-nine polyps with atypism of the large intentine were classified into 63 benign adenomas, 30 carcinomas and 31 borderline lesions from the view-point of their cellular atypism (Table 1).

 1) Two-dimensional analysis of structural atypism (Table 2): The average of index of structural atypism (I.S.A. = area of glands per unit area/area of the stroma per unit area) was as follows; carcinoma 5.41±1.61, benign adenoma 2.76±0.93 (Fig. 5, Table 5). I.S.A. of benign adenomas showed a normal distribution but that of carcinomas did not. I.S.A. of borderline lesions was 5.44±1.08 and was included within the range of I.S.A.of carcinomas.

 2) Three-dimensional analysis of structural atypism: Anastomosis between two glands and/or loop in a gland are observed in adenomas and carcinomas of the large intestine by means of reconstruction of specimens serially sectioned (Fig. 1 and 8). Furthermore, there are the branchings of glands in them. These can be identified as the structural atypism of three dimensions, because the norma1 mucosa of the large intestine consists of non-branched tubules.

 a) The average number of branching of a gland of carcinoma was 2.2 times more than that of benign adenoma. That of borderline lesion was 1.3 times more than that of benign adenoma (Table 6).

 b) Applying topological homotopy, Betti number of one dimension (P1=no.of anastomosis + no.of loop) of the glands of carcinomas was 2.2 times more than that of benign adenomas. That of borderline lesions was 1.1 times more than that of benign adenomas (Table 7).

 c) The structural atypism of three dimensions could be expressed topologically as minus Euler's characteristics (-K) in a plane (Fig. 2). Frequency of -K glands per unit area of carcinoma was three times higher than that of benign adenoma. That of borderline lesion was included within the range of that of carcinoma (Table 8).

 3) Twenty-six borderline lesions were divided into carcinomas and benign adenomas by comparing I.S.A. and frequency of -K glands with those of carcinomas and benign adenomas. The obtained results were as follows; two were benign, four were malignant, but the remaining 20 lesions (77%) could not be determined, that is, so-called “borderline”from the viewpoint of both cellular and structural atypism (Table 10).

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