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      Morphometrical Analysis of Structural Abnormality of Tubular Tumors of the Stomach with Image Processing

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          Abstract

          Four indices, index of tubular density, index of dispersion of tubular size, degree of complexity of tubular shape and frequency of complex‐shaped tubuli, were defined to quantify the structural abnormalities of gastric tumors in morphometrical analysis by image processing. The values of each index corresponded well with the degree of each structural abnormality found pathologically. These indices were considered to be valid for representing their respective structural factors. There were significant differences among the mean values of the scores calculated by a formula using all 4 indices of benign tubular adenoma, borderline lesion and well‐differentiated type tubular adenocarcinoma (P<0.05). Therefore, the discriminant formula was considered to be valid for integrating these indices and for representing structural abnormality of gastric tubular tumors.

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          The value of morphometry to classic prognosticators in breast cancer.

          P H Kurver, Roel C. J. Hermans, Egbert van Nes … (1985)
          In 271 breast cancer patients with adequate follow-up for at least 5.5 and maximally 12 years, the value of morphometry to classic prognosticators of breast cancer (tumor size and axillary lymph node status) was assessed. Previous studies had indicated the value of this quantitative microscopic technique. Apart from quantitative microscopic features, subjective qualitative features such as nuclear and histologic grade were assessed as well. Univariate life-table analysis showed the significance (p less than 0.001) of several features such as lymph node status, tumor size, nuclear and histologic grade, and several morphometric variables (mitotic activity index, mean and standard deviation of nuclear area). Cellularity index was also significant (p = 0.02). Survival analysis with Cox's regression model, using a stepwise selection as well as backwards elimination, pointed to three features: mitotic activity index, tumor size, and lymph node status. Mitotic activity was the most important prognostic feature, but the combination of these three features in a multivariate prognostic index had even more prognostic significance. Kaplan-Meier curves showed that the 5-year survival of lymph node-negative patients (n = 146) is 85%, versus 93% in patients with a "good prognosis index" (n = 150). For lymph node-positive patients (n = 125), 5-year survival was 55%, compared with 47% in the "high index" (poor prognosis) patients (n = 121). Logistic discriminant analysis with 5.5-year follow-up as a fixed endpoint (191 survivors and 80 nonsurvivors) essentially gave the same results. Application of two instead of one decision threshold (e.g., numerical classification probability 0.60 and 0.40) decrease the number of false-negative and false-positive outcomes, however, with a number of patients falling in the class "uncertain." Thus, in agreement with other studies, morphometry significantly adds to the prognosis prediction of lymph node status and tumor size. Mitotic activity index is the best single predictor of the prognosis. An additional index advantage is that the multivariate model results in a continuous index variable that can be subdivided in many classes with an increasing risk of recurrence, so that more refined clinical therapeutic decision making is possible in individual patient care. The morphometric techniques are inexpensive and fairly simple and therefore can be applied in most pathology laboratories.
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            Morphometric analysis of gallbladder adenocarcinoma: discrimination between carcinoma and dysplasia.

            S Nakajo, M Yamamoto, E Tahara (1989)
            To characterize the cytological features of well differentiated adenocarcinoma of the gallbladder, a comparative morphometric analysis was made using 35 histologically classified cases of invasive well differentiated adenocarcinoma, 13 cases of mild dysplasia, 19 cases of severe dysplasia, and 22 control gallbladders. The variables analyzed were nucleocytoplasmic (N/C) ratio and nuclear area (N.A.). Both the mean values of N/C ratio and N.A. demonstrated a progressive increase from control to mild dysplasia, to severe dysplasia and to carcinoma. The differences were statistically significantly different. Discriminant analysis was made with a set for learning and a set for testing, selected from the 89 lesions with random numbers. Using this discriminant function, all the cases except one carcinoma were discriminated as carcinoma, and all the cases of control, adenoma, and mild dysplasia were discriminated as benign lesions. However, cases of severe dysplasia were subdivided into benign or malignant. These results indicate that morphometric analysis clearly differentiates carcinomas from benign lesions, and that the dysplastic mucosal lesions can be divided into benign and malignant, although some difficult borderline lesions exist.
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              Borderline or malignant ovarian tumour? A case report of decision making with morphometry.

              J. P. Baak, G Van der Ley (1984)
              A young woman presented with bilateral ovarian tumours. Multiple sections of each tumour were shown to many pathologists for consultation; some considered the tumours to be borderline, whereas others thought that one or both of them was malignant. Morphometry showed that the numerical classification probabilities for borderline tumour were 0.78 for the left ovarian tumour and 0.85 in the right. The lesions were therefore regarded as borderline tumours and no additional chemotherapy was given. Three years after the second operation the patient is alive and well without clinical or biochemical evidence of recurrence. Most patients with borderline tumours who die from the disease do so in the first two years after the operation. This young patient was prevented from severe overtreatment by the application of morphometry, illustrating its use in this area of diagnostic gynaecopathology.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Jpn J Cancer Res
                Journal ID (iso-abbrev): Jpn. J. Cancer Res
                Journal ID (doi): 10.1111/(ISSN)1349-7006a
                Journal ID (publisher-id): CAS
                Title: Japanese Journal of Cancer Research : Gann
                Publisher: Blackwell Publishing Ltd (Oxford, UK )
                ISSN (Print): 0910-5050
                ISSN (Electronic): 1876-4673
                Publication date (Print): September 1991
                Volume: 82
                Issue: 9 ( doiID: 10.1111/cas.1991.82.issue-9 )
                Pages: 1015-1021
                Affiliations
                [ 1 ]Division of Internal Medicine, National Cancer Center Hospital, 5‐1‐1 Tsukiji, Chuo‐ku, Tokyo 104
                [ 2 ]Division of Surgery, Tsuchiura Kyohdoh General Hospital, 11‐7 Manabe Shin‐machi, Tsuchiura 300 and
                [ 3 ]First Department of Pathology, Tokyo Medical and Dental University, 1‐5‐45 Yushima, Bunkyo‐ku, Tokyo 113
                Author notes
                [*] [* ]To whom correspondence should be addressed.
                Article
                Publisher ID: CAE1015
                DOI: 10.1111/j.1349-7006.1991.tb01937.x
                PMC ID: 5918607
                PubMed ID: 1938596
                SO-VID: 3420a519-213b-4665-b716-b819481a4f16
                History
                Page count
                References: 21, Pages: 7
                Categories
                Subject: Article
                Custom metadata
                source-schema-version-number 2.0
                cover-date September 1991
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_NLMPMC version:4.6.9 mode:remove_FC converted:04.11.2015

                Keywords: gastric tumor,morphometry,structural abnormality
                Data availability:
                Keywords: gastric tumor, morphometry, structural abnormality

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