用形态测量方法研究卵巢上皮性肿瘤的诊断及预后

背景与目的:形态测量学在肿瘤的病理诊断及预后评估中日渐重要。本文探讨图像分析法在卵巢上皮性肿瘤的诊断及预后中的意义。方法:联合应用图像分析、AgNOR计量分析及DNA含量测定3种形态测量学方法,对110例原发性卵巢上皮性肿瘤的诊断及预后进行研究,选用的参数为核面积(nucleararea,NA)、核周长(nuclearperimeter,NP)和核形状因子(nuclearformfactor,NFF)、DNA含量(DNAcontent,DC)、DNA指数(DNAindex,DI)、G0/G1期细胞百分率(percentageofG0/G1phases,P2c)、高倍体细胞百分率(percentageofDNAmultiploid,P>4c),并于光镜下进行AgNOR计数。结果:(1)良性、交界性及恶性3组卵巢上皮性肿瘤相比较,NA、NP、NFF、DC、DI及AgNOR计数在各组间差异有极显著性意义(P<0.01或P<0.001)。(2)形态测量学结果与预后关系研究表明,卵巢上皮性癌患者生存≥5年及<5年两组病例中,NA、NP、NFF参数两组间差异有显著性或极显著性意义(P<0.05或P<0.01),不同的图像分析结果提示其预后不同。AgNOR计数与上皮性卵巢癌患者的生存时间呈负相关(r=-0.73,P<0.001)。DNA高倍体含量与上皮性卵巢癌患者生存时间亦呈负相关(r=-0.75,P<0.001)。结论:形态测量学可为不同性质的卵巢上皮性肿瘤的诊断和预后提供可靠的客观依据。

Diagnosis and prognosis of ovarian epithelial tumor with morphometry

BACKGROUND & OBJECTIVE: Morphometry for diagnosis and prognosis of tumor becomes important. This study was designed to evaluate the efficiency of morphometry for diagnosis and prognosis of the patients with ovarian epithelial tumor. METHODS: A total of 110 patients with ovarian epithelial tumor were studied by three morphometrical methods (image analysis, determination of DNA content, and quantitative analysis of AgNOR). Nuclear area (NA), nuclear perimeter (NP), nuclear form factor (NFF), DNA content (DC), DNA index (DI), percentage of DNA multiploid (P > 4c), and percentage of G0/G1 phases (P2c) were determined by morphometrical instrument. AgNOR was counted under light microscope. RESULTS: (1) The results in these three groups of benign, borderline, and malignant ovarian epithelial tumors: the differences of all parameters (NA, NP, NFF, DC, DI, AgNOR counts) among these groups have a extremely significant statistical difference (P < 0.01 and P < 0.001). (2) A study on prognosis: NA, NP, and NFF between two groups of patients (survival > or = 5 years and < 5 years) with ovarian epithelial carcinoma have a significant difference(P < 0.05 and P < 0.01), this means different results of image analysis indicate different survival. AgNOR counts have a close correlation with month of the survivors (r = -0.73, P < 0.001). The P > 4c had a relation to month of survivors (r = -0.75, P < 0.001). CONCLUSIONS: Morphometry can provide reliable parameters for diagnosis and prognosis of the patients with different kinds of ovarian epithelial tumors.