支气管粘膜上皮不典型增生细胞的形态变化及意义

目的　探讨肺癌早期诊断及随访监测的定量指标。方法　应用HE染色、图像分析技术 ,对正常支气管上皮、鳞化上皮、不典型增生上皮及鳞癌Ⅰ级共 86例支气管粘膜活检组织石蜡切片进行细胞形态定量分析。结果　核面积、核面积差异度、核周长、核周长差异度、核形状因子、核形状因子差异度、核体密度、核浆比值、细胞周长、细胞周长差异度 10项参数随病变阶段的递进呈增加或减少趋势 ;核参数的变化方向反映了癌前病变的发展趋势。结论　支气管粘膜中、重度不典型增生是粘膜从良性向恶性转变的关键阶段 ,细胞形态定量分析对肺鳞癌癌前病变的诊断、监测具有积极意义

The quantitative analysis of cytomorphology in atypical metaplastic bronchial epithelium.

Objective To study the quantitative cytomorphologic parameters in early diagnosis and follow-up of lung cancer.Method With HE staining and image analysis,quantitative analysis of cytomorphology was made on paraffin sections of 86 specimens of bronchial mucosa,sampled by bronchoscopic biopsy,which would reflect a series of events from squamous metaplastic bronchial epithelium to invasive bronchogenic carcinoma.Result 8 nuclear parameters (area,deviation of area,perimeter,deviation of perimeter,shape factor,deviation of shape factor,volume density nucleus,nucleus/plasma ratio)and 2 cellular nodes(perimeter,deviation of perimeter)increased or decreased parallelly with advancing nuclear atypia.Conclusion The two stages of the moderate and severe atypical metaplasia of bronchial epithelium are the critical ones changing from benign to malignant.The quantitative analysis of cytomorphology is useful for discovering and following up the precancerous lesions of bronchogenic squamous cell carcinoma.