胃粘膜上皮异型增生的形态测量研究

世界卫生组织“胃癌国际研究组病理学专门小组”根据胃粘膜的组织结构紊乱、细胞异型性和分化异常的程度,把胃上皮异型性(或结构不良gastric dysplasia)分为轻、中、重三级。其判断标准多凭经验,难免带主观意断性,以致同一病变的诊断和分级在不同、甚至同一病理学者往往得出不同的结论,给临床处理造成一定困难。据此,我们采用ASM68K

A Morphometric Study of Gastric Mucosal Epithelial Dysplasia

In this article, 83 cases of gastric mucosal specimens resected from patients with gastric ulcers or adenocarcinoma were divided into simple epithelial metaplasia, dysplasia and differentiated adenocarcinoma groups. By the application of automatic image analyzer (model ASM 68k, LIETZ Co, West Germany), (1) perimeter of the glandular outer fringe(P_1), its containing area(A_1)and the diameter(D_1) of a circular area equal to A_1; (2) perimeter of the irregular circle (P_2) formed by the curve joining together the cellular nuclei along the lumen of the gland, its containing area(A_2) and the diameter (D) of a circular area equal to A_2; (3) perimeter (P_3) of the inner margin of the glandular lumen, its containing area (A_3) and diameter(D_3) of a circular area equal to A_3 were calculated synchronously. Then, P_1/D_1, P_2/D_2 and ING (index of nucleus-gland ratio) i.e., the total area of cellular nuclei (A_1-A_2)/total area of cells (A_1-A_3) in a single body of gland, were determined. The results revealed that the P_1/D_1, P_2/D_2 and ING values in sinple epithelial metaplasis, dysplasia and differentiated adenocarcinoma groups would increase along with the degree of dysplasia of the lesion. Moreover, very significant differences(P<0.01) of the three values mentioned above existed between these groups. The authors suggest that P_1/D_1, P_2/D_2 and ING could be taken as an objective morphometric index for quantitative diagnosis and grading of gastric mucosal epithelial dysplasia.