甲状腺乳头状癌核内包涵体及核的形态结构定量分析

目的:定量揭示甲状腺乳头状癌核内包涵体及核的几何形态结构特点，为甲状腺乳头状癌的病理诊断提供定量诊断参数。方法:取甲状腺乳头状癌100例，常规切片、HE染色，在40倍物镜下采集核内包涵体及核的图像，用Image-Pro Plus测试包涵体及核的面积、周长、长轴、短轴、形状因子PE（Form PE）、形状因子AR（Form AR）、规化形状因子（RFF）、轴比、核内包涵体的面积密度以及包涵体与核质的面积比。结果:（1）甲状腺乳头状癌核内包涵体的面积约为（13.575±9.045） μm2（95%CI 13.339~13.810），其在核内的面积密度约为25.761%±10.683%（95%CI 25.483~26.039）；其周长约为（12.720±4.275） μm（95%CI 12.609~12.831），长轴（4.547±1.466） μm（95%CI 4.509~4.585），短轴（3.482±1.178） μm （95%CI 3.451~3.512）；其轴比约为0.772±0.121（95%CI 0.769~0.775），Form PE、Form AR和RFF约等于1；其与核质的面积比约为0.380±0.237（95%CI 0.374~0.386），其面积、周长、长轴和短轴的变异系数为66.6%、33.6%、32.2%、33.8%。（2）具有核内包涵体的癌细胞，其核的面积、周长、长轴和短轴及其相应变异系数显著大于没有核内包涵体的细胞核（P<0.05）。（3）核内包涵体、含有核内包涵体的核及没有核内包涵体的核，其面积、周长、长轴和短轴的频数分布均呈正偏态分布。结论:（1）甲状腺乳头状癌核内包涵体形状大致呈圆形；约为核面积的1/4，核周长、长轴和短轴的1/2；其面积、周长、长轴和短轴的变异程度均较大。（2）具有包涵体的癌细胞，其核的异型性明显，诊断阅片时应重点观察。（3）包涵体及核的上述尺寸参数的频数分布均呈正偏态分布。

Quantitative analysis of the morphological structures of intranuclear inclusion bodies and nuclei in papillary thyroid carcinoma

Objective To quantify the geometrical and structural features of intranuclear inclusion bodies and nuclei in papillary thyroid carcinoma, and to provide quantitative diagnostic parameters for the pathological diagnosis of papillary thyroid carcinoma. Methods A total of 100 cases of thyroid papillary carcinoma were sectioned and stained with hematoxylin-eosin (HE). The images of inclusion bodies and nuclei were collected using a 40× objective lens, and their geometrical and structural features, including area, perimeter, long axis, short axis, Form PE, Form AR, common form factor (RFF), axial ratio, the area density of inclusion bodies and area ratio of inclusion bodies to the nucleoplasm, were obtained using Image-Pro Plus. Results (1) The area of intranuclear inclusion bodies in papillary thyroid carcinoma was approximately (13.575±9.045) μm2 (95% CI 13.339-13.810), and their area density in the nuclei was approximately 25.761%±10.683% (95% CI 25.483-26.039). The perimeter of the inclusion bodies was approximately (12.720±4.275) μm (95% CI 12.609-12.831 μm), with a long axis of (4.547±1.466) μm (95% CI 4.509~4.585) and a short axis of (3.482±1.178) μm (95% CI 3.451-3.512 μm). The axis ratio was approximately 0.772±0.121 (95% CI 0.769-0.775) Form PE, Form AR and RFF were approximately equal to 1 and the area ratio of inclusion bodies to the nucleoplasm was approximately 0.380±0.237 (95% CI 0.374-0.386). The coefficients of variations were 66.6%, 33.6%, 32.2% and 33.8% for the area, perimeter, long axis and short axis, respectively. (2) The area, perimeter, long and short axes, and their corresponding coefficients of variations were significantly greater in cancer cells with intranuclear inclusion bodies than in nuclei without intranuclear inclusion bodies (P<0.05). (3) The frequency distributions of the area, perimeter, long and short axes of intranuclear inclusion bodies, nuclei containing intranuclear inclusion bodies and nuclei without intranuclear inclusion bodies were all positively skewed. Conclusion (1) The intranuclear inclusion bodies in papillary thyroid carcinoma is roughly circular, with approximately 1/4 of the nucleus area and 1/2 of the nucleus perimeter, long axis, and short axis. These parameters all exhibited a large degree of variation. (2) The heterogeneity of the nucleus of carcinoma cells with inclusion bodies is apparent, and should be pay attention to during diagnosis. (3) The frequency distribution of the above mensioned parameters of inclusion bodies and nuclei are positively skewed.