Japanese

Objective Standardization of Grade of Struc-tural and Cellular Atypicalities in Epithelial Tumors of the Large Intestine: The Morphometric Analysis of Biopsy Material S. Shibuya 1 , K. Nakamura 1 , H. Ikezono 1 , S. Togo 1 , M. Kikuchi 1 1Department of Pathology, Institute of Basic Medical Sciences, the University of Tsukuba, School of Medicine pp.1341-1348
Published Date 1984/12/25
DOI https://doi.org/10.11477/mf.1403109525
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 The purpose of this paper is to standardize objectively structural and cellular atypias of adenoma and carcinoma of the large intestine.

 Biopsy specimens taken from 324 cases of polyps and carcinomas of the large intestine were histologically classified into three groups, definitely benign adenoma and definite carcinoma situated at the mucosa, and adenoma with severe atypia except the former two. Number of them consists respectively of 190, 59, and 46 cases in that order (Table 1).

 1) The two dimensional analysis of structural atypia (Table 2) : the average of the Index of Structural Atypia (ISA=area of glands per unit area/ area of stroma per unit area) was as follows ; benign adenoma 2.34±0.82, borderline lesion 3.84±1.04, carcinoma 4.34±1.24 (Fig. 2, Table 3). ISA of benign adenomas and borderline lesions showed a normal distribution. Application of “t” test shows a p of less than 0.05 for the difference in the mean value of the indices among them.

 2) The structural atypia of three dimensions could be expressed topologically as minus Eular's characteristics (-K) in a plane (Table 2). The average of Index of Double Doughnuts (IDD=number of -K glands per unit area/number of glands per unit area×100) was as follows ; benign adenoma 7.2±7.2, borderline lesion 12.6±9.6, carcinoma 42.6±31.4 (Table 4, Fig. 3). Application of “t” test shows a p of less than 0.01 for the difference in the mean value of the indices among them.

 3) The average of Index of Nucleus-Gland ratio (Fig. 1) (ING=area of nucleus per gland/area of cells per gland) was as follows ; benign adenoma 0.37±0.06, borderline lesion 0.46±0.06, carcinoma 0.57±0.06 (Table 5, Fig. 4). ING of benign adenomas and borderline lesions showed a normal distribution. Application of “t” test shows a p of less than 0.01 for the difference in the mean value of the indices among them.

 4) Forty-six borderline lesions were divided into carcinomas and benign adenomas by using ISA,ING (more than mean+2SD) and IDD's values (3.69×mean) of benign adenoma. The obtained results were as follows ; sixteen were benign, seven were malignant, but the remaining 23 lesions (50%) could not be determined, that is, so-called “borderline” from the view-point of both cellular and structural atypia (Fig. 5).


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