胃管状上皮性肿瘤细胞三维结构的体视学研究

目的用体视学方法定量揭示胃管状上皮性肿瘤细胞三维形态结构的特点及变化规律,为病理诊断的定量分析与预后判断奠定基础。方法取外科手术切除的胃腺癌35例、腺瘤8例、癌旁正常粘膜19例。按组织病理学技术常规对所取组织固定并石蜡包埋、切片、HE染色。显微获取图像,用Image-Pro图像分析软件对癌细胞、腺瘤及正常上皮进行定量测试。测试细胞核的体积密度Vvn.c、表面积密度Svn.c、数密度Nvn.c、表面积与体积比Rsvn、平均自由程λn、平均体积vn.c及核浆比Rnp,测试腺上皮细胞的线参照数密度NLS。结果Vvn.c、Svn.c、Rsvn、λn、vn、Rnp及NLS在胃癌、胃腺瘤和正常胃组织之间的差异具有统计学意义,其中Vvn.c、Svn.c、Rnp及vn按胃癌、胃腺瘤和正常胃组织顺序依次减少,而Rsvn和λn则依次增多; 胃腺瘤的NLS较胃癌及正常胃增大,胃腺癌的NLS则高于正常胃。Nvn.epi在各组间差异无显著性。结论Vvn.c、Svn.c、Rsvn、λn、vn、Rnp及NLS的变化在胃良、恶性肿瘤及正常胃组织间具有显著的差异性及规律性,其定量分析有助于胃良、恶性上皮性肿瘤的辅助诊断。

Stereological study on three-dimensional structure of gastric neoplastic cells

Objective To quantitatively reveal the characteristics and changing rules of the three-dimensional structure of gastric neoplastic cells by stereology, and to lay the foundation for quantitative diagnosis and prognosis of the diseases. Methods The tissue samples were obtained from surgical specimens of gastric neoplasms, including 35 gastric carcinomas, 8 gastric adenomas and 19 normal gastric tissues taken from autopsy. Hematotoxylin and eosin stained parraffin sections were preparedaceording to routine histopathological techniques. Stereological parameters were measured, and statistical tests were performed by Image-Pro analysis software. Results The stereological paraments of Vvn.c,Svn.c,Rsvn,λn,vn, Rnp and NLS showed statisticallysignificant difference between the gastric adenocareinoma, gastric adenoma andnormal gastric tissue. The Vvn.Vn.c Rop and va were decreased orderly and Rn and λn increased orderly; the NLS of gastric adenoma was larger than that of gastric adenocarcinoma and normal gastric tissue. The NLS of gastric adenocarcinoma was larger than that of normal gastric tissue. Conclusions The diversity of V Svn.c, Vn.c R.p and NLS between gastric adenocarcinoma, gastric adenoma and normal gastric is evident and regularly, and the quantitative analysis of these parameters is useful in auxiliary differential diagnosis between those diseases.