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Objectification of Histologic Diagnosis on Protruded Lesion of Atypical Epithelium and Differentiated Carcinoma of the Stomach: Numerical Value of Structural Atypism by Morphometrical Analysis M. Kikuchi 1 , K. Nakamura 1 , H. Akabane 1 , S. Shibuya 1 1Department of Pathology, The University of Tsukuba, School of Medicine pp.1117-1125
Published Date 1984/10/25
DOI https://doi.org/10.11477/mf.1403109617
  • Abstract
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 Generally speaking, histological interpretation of the tumor of the stomach has been experientially and subjectively done by pattern recognition of cellular and structural atypisms. Objectification of cellular atypism has been studied by means of measurement of DNA values. However, objectification of the structural atypism has never been studied.

 Recently, objectification of structural atypism by means of morphometric analysis has been reported on epithelial tumor of the large intestine (Togo S, et al, 1982)3), but has not yet been studied on epithelial tumor of the stomach.

 The purpose of this study is to analyse morphometrically the structural atypism on protruded lesions of atypical epithelium (adenoma) and differentiated carcinoma of the stomach, and to examine whether morphometric value obtained from each lesion is useful for differential diagnosis or not.

 Materials for this study are protruded lesions of atypical epithelium of intestinal type (adenoma of intestinal type) and differentiated carcinoma in biopsy and surgical specimens (Tables 1, 2 and 3). These lesions were divided into three groups: definitely benign (Fig.1), definitely malignant (Fig.2), and borderline groups (Fig.3). Metaplastic mucosa of intestinal type was used as a control group.

 In histological tissues of the materials, area of glands and area of stroma per unit area were measured by image analyser (Fig.4), and ratio of the area of glands to the area of stroma per unit area was calculated in each lesion. It may be considered that the ratio indicates a summation of density and irregular size of gland in histological preparation. The ratio has been called as index of structural atypism (in the following abbreviated as ISA).

 (1) The mean values of ISA measured on biopsy specimen were as follows: intestinalized mucosa as a control was 1.08±0.40, the definitely benign group 2.31±0.71, the borderline group 2.94±0.48, and the differentiated carcinoma group 3.89±0.96 (Table 4). Further, these ISA values showed a normal distribution in each group. Application of t-test among them shows statistically significant difference (p<0.01).

 (2) The mean values of ISA measured on surgical specimen were as follows: intestinalized mucosa was 1.17±0.40, the definitely benign group 2.25±0.73, the borderline group 2.81±0.64, and the differentiated carcinoma group 4.09±1.71 (Table 5). These ISA values showed a normal distribution except the differentiated carcinoma group (Figs. 6 and 7). Application of t-test among them yields a p value of less than 0.01.

 (3) ISA of biopsy and surgical specimens showed almost the same value in each group (Table 6). The ISA values of the control and three groups are arranged in the order of severity of structural atypism.

 Consequently, it may be concluded from these data obtained that the value of ISA is useful to diagnose objectively whether an atypical epithelial lesion of the stomach is benign or malignant.


Copyright © 1984, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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