NUCLEAR MORPHOMETRY AS A PREDICTOR OF DISEASE OUTCOME IN GASTRIC CANCER

Nuclear morphometric features including nuclear area (NA), nuclear perimeter (PE), their variation (SDNA, SDPE), and mean largest and smallest nuclear diameters (Dmax, Dmin) were examined in 116 patients with stage I–II gastric adenocarcinoma. Morphometric measurements were compared with tumour differentiation, depth of invasion (pT), lymph node status (pN), and Lauren classification. All morphonuclear features were significantly larger in the intestinal type than in the diffuse type of cancer. None of the morphometric variables was related to TNM status or tumour size. Nuclear area and perimeter and their variation were closely related to survival in univariate analysis, patients with small and regular nuclei surviving longer. In the multivariate analysis, pT, pN, perineural invasion, and the standard deviation of nuclear perimeter (SDPE) were independent predictors of survival. Nuclear morphometry is a quantitative, objective, and highly reproducible method of revealing malignant features in several neoplasms. The results of the present study suggest that nuclear morphometric data may help in defining prognosis in gastric cancer. © 1997 by John Wiley & Sons, Ltd.     

Clinical decision making in Barrett's oesophagus can be supported by computerized immunoquantitation and morphometry of features associated with proliferation and differentiation

Grading of dysplasia in Barrett's oesophagus has a therapeutic impact, but subjective grading is associated with substantial observer variation. Quantitative pathological methods could help to achieve a more accurate and reproducible diagnosis. In the present study, the immunoquantitation of p53 and Ki67 and the morphometric analysis of features associated with proliferation and differentiation were evaluated for this purpose. In slides of 35 oesophagectomy specimens, 73 areas that displayed either no dysplasia (ND), low-grade dysplasia (LGD), high-grade dysplasia (HGD), or intramucosal carcinoma (ImCa) were initially considered. Agreement on double blind examination by two experienced pathologists was reached in 58 areas, which were used as the ‘learning set’. The 15 areas of disagreement were used as a second set. In the univariate analysis, the most significant differences in the learning set were found for Ki67, p53, stratification index (SI), mean nuclear area, and volume. Further multivariate analysis showed that for discrimination between ND and LGD, the combination of Ki67 and SI resulted in 94 per cent correctly classified areas. Likewise, for the discrimination between LGD and HGD, Ki67 and SI were the most powerful combination (again, 94 per cent of areas classified correctly). The discrimination between HGD and ImCa with any combination of the quantitative parameters never exceeded 80 per cent correct classification. The addition of p53 was of no value in improving the discrimination of ND vs. LGD, or of LGD vs. HGD. In the 15 original disagreement areas of the initial set of 73, three of the five ND/LGD areas could be uniquely classified as either ND or LGD by Ki67 and SI. Moreover, three of the four LGD/HGD disagreement areas could be uniquely classified with the combination of Ki67 and SI as either LGD or HGD. We conclude that the quantitative assessment of cytometric and morphometric features associated with proliferation and differentiation (especially Ki67 and SI) can be a valuable adjunct tool for clinical decision making in Barrett's oesophagus. © 1998 John Wiley & Sons, Ltd.     

White matter of the cerebellum of the chicken (Gallus domesticus): A quantitative light and electron microscopic analysis of myelinated fibers and fiber compartments

Low magnification light microscopic examination of the white matter in appropriately stained avian and mammalian cerebellum reveals a mediolateral succession in which areas of large, heavily myelinated fibers alternate with areas containing nearly exclusively small fibers. A large fiber accumulation (LFA) and its medially adjoining small fiber area (SFA) form a fiber compartment, which, with related parts of cortex and central nuclei, constitutes a so-called cerebellar module. The composition and the apparent mediolateral heterogeneity of cerebellar fiber compartments was quantified in the chicken by morphometrical analysis of myelinated fiber profiles in light (LM) and electron (EM) microscopic micrographs. In LM versus EM, approximately 37% of the myelinated fiber population is neglected. This deficit concerns profiles that are smaller than 1.2 μm² (diameter < 1.2 μm). EM analysis is therefore considered a prerequisite and forms the main part of this study. The myelinated fiber population has a left-skewed log normal size distribution. Ninety-nine percent of the myelinated fibers fall within the range of 0.1 to 20 μm² (diameter = 0.4–5.0 μm) and 90% are even smaller than 7 μm² (diameter < 3.0 μm). Small fibers are abundant in both parts of the compartment. Statistical comparisons provide quantitative confirmation of the LM distinction of LFAs and SFAs. It appears, moreover, that, apart from typical LFAs and SFAs, transitional zones rather than sharp borders can be distinguished between the two. The medial border of the LFA appears to be more sharply defined than its lateral border. Distinct mediolateral fluctuations were found with respect to fiber density (166–243 fibers/1,000 μm²), mean profile area (2.4–4.0 μm²), and interspace (31–47%). These differences reflect the contrast between LFA (lower density, larger mean profile area) and SFA (higher density, smaller mean profile area). The interspace discriminates less well between LFA and SFA but is often smaller in the LFA and larger in the SFA. The presented quantitative characteristics of mediolateral heterogeneity in the cerebellar fiber layer can be used as reference for morphometric studies on the different fiber systems of the cerebellar white matter and the functional organization of the compartments. © 1996 Wiley-Liss, Inc.     

Effects of spinal cord stimulation on voxel-based brain morphometry in patients with failed back surgery syndrome

ObjectiveDespite the clinical effectiveness of Spinal Cord Stimulation (SCS), potential structural brain modifications have not been explored. Our aim was to identify structural volumetric changes during subsensory SCS, in patients with Failed Back Surgery Syndrome (FBSS).MethodsIn this cohort study, twenty-two FBSS patients underwent a magnetic resonance imaging protocol before SCS and 3 months after SCS. Clinical parameters were correlated with volumetric changes, calculated with voxel-based morphometry.ResultsAfter 3 months, a significant volume decrease was found in the inferior frontal gyrus, precuneus, cerebellar posterior lobe and middle temporal gyrus. Significant increases were found in the inferior temporal gyrus, precentral gyrus and the middle frontal gyrus after SCS. Additionally, significant increases in volume of superior frontal and parietal white matter and a significant decrease in volume of white matter underlying the premotor/middle frontal gyrus were revealed after SCS. A significant correlation was highlighted between white matter volume underlying premotor/middle frontal gyrus and leg pain relief.ConclusionsThis study revealed for the first time that SCS is able to induce volumetric changes in gray and white matter, suggesting the reversibility of brain alterations after chronic pain treatment.SignificanceVolumetric brain alterations are observable after 3 months of subsensory SCS in FBSS patients.     

小脑共济失调为主要症状的多系统萎缩患者脑99mTc-SPECT影像学特征分析

目的探讨小脑共济失调症状为主的多系统萎缩(MSA-C)患者的脑局部血流量水平变化规律。方法以在我院神经内科就诊的12例MSA-C患者与25名正常对照者为研究对象,进行锝[~(99m)Tc]双半胱乙酯为显像剂的脑单光子发射计算机断层成像(SPECT)检查以评价脑局部血流量,其SPECT影像以SPM8、xjview9软件进行基于体素的形态学分析(VBM),将与正常对照在脑局部血流量有上统计学差异的区域投射至标准脑模版上,并分析其主要累及脑区、峰值位置、最大t值等特征。结果与正常对照者相比较,MSA-C患者主要出现小脑双侧小脑后叶、小脑蚓部、脑桥的脑局部血流量显著下降(P 0. 01FDR校正,簇水平);未发现有明显统计学意义上的大脑皮质及壳核的脑局部血流量降低。结论 MSA-C患者主要可出现小脑及脑桥的脑局部血流量降低。     

AgNORs形态定量在大肠癌病理及预后判定中的应用

目的 :探讨AgNORs形态定量与大肠癌临床病理及预后的关系。 方法 :应用图像分析系统对 4 0例大肠腺癌、2 0例大肠腺瘤、2 0例正常粘膜细胞核中AgNORs颗粒进行形态定量分析。结果 :大肠腺癌AgNORs计数、颗粒面积、颗粒面积 /核面积均明显高于腺瘤及正常组 ,而形态系数则明显降低 (P <0 .0 5 ) ,各组间比较差异有显著性 ;同时生存 5年以上患者组AgNORs计数及面积均明显低于生存 5年以下者 ,P <0 .0 5。 结论 :AgNORs形态定量指标检测可作为大肠肿瘤良、恶性鉴别诊断分级及预后判断的一项定量指标。     

口底鳞状细胞癌形态计量学研究的临床意义

目的　探讨细胞形状因子(FC)和平均光密度参数在口底鳞癌诊断中的意义。方法　28例口底鳞癌石蜡标本切片免疫组化(SABC)染色,应用图像分析仪测定原发灶和颈淋巴结细胞胞核形状因子(FC)和平均光密度参数。结果　经CK10和CK14单克隆抗体标记后,淋巴结有无转移或病理分级不同患者的原发灶细胞胞核中FC和平均光密度参数有显著性差异(P<0·05或<0·001),而临床分期不同的患者,其差异无显著性(P>0·05);颈淋巴结中转移阳性和阴性间的FC和平均光密度有显著性差异(P<0·05或<0·001)。结论　CK10和CK14表达中细胞的FC 和平均光密度参数可作为评估口底鳞癌浸润、转移潜能的临床参考指标。