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  • 1
    ISSN: 1365-2559
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Endometrial hyperplasias and carcinomas have been investigated by quantitative microscopical methods. The aim of this study was to develop an objective method of histopathological diagnosis because of the great subjective variability of these endometrial conditions. A total of 79 cases were studied. Only those were included, which, after re-examination of the material by different pathologists, were regarded as mild atypical hyperplasia (38 cases), marked atypical (adenomatous) hyperplasia (11 cases), well and moderately differentiated adenocarcinoma (19 and 11 cases, respectively). There are many significant differences between these four groups. Stereological features contained the most important information, whilst nuclear features were less successful discriminators. The volume percentage of the epithelium and of the glands and the inner surface density of the glands showed the most significant differences between adenomatous hyperplasia and well differentiated carcinoma. On the basis of these findings, a quantitative model is suggested which might give more insight into the development of these abnormalities, assuming a gradual transition from one to another. The great advantage of the quantitative analysis of data over subjective impressions, it that is is objective, and provides consistently reproducible results. The present results may be especially useful when histopathological diagnosis is in doubt. It is concluded that application of quantitative microscopy in the discrimination of endometrial hyperplasia and carcinoma in histopathology is feasible.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Histopathology 6 (1982), S. 0 
    ISSN: 1365-2559
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Morphometric methods were applied to predict the clinical course of individual patients with breast cancer. Measurement of tumour diameter, assessment of mitotic and cellular indices, and quantitative microscopy of nuclear features were assessed together with nuclear features and histological grades. Of the tumours from 78 patients investigated, 42 had died from metastases within 6.5 years (‘non-survivors’), while the other 36 were alive and well without evidence of metastases at the end of the follow-up period (minimum 6.5 years) (‘survivors’). If the tumours of the 42 non-survivors are compared with those of 36 survivors, there are many reproducible significant differences, the most important being cellularity index and mitotic activity index, followed by quantitative microscopical nuclear parameters and nuclear and histological grade. Discriminant analysis, of the quantitative microscopical data alone showed 82% of all patients to be correctly classified as survivor or non-survivor. By contrast with the axillary lymph node invasion status alone, or the tumour diameter and axillary lymph node status together, 59% and 64% of the patients were predicted correctly as survivor or non-survivor. With a more realistic statistical approach of discriminant analysis, 78% of the patients were classified correctly with quantitative microscopy, in place of 54% with the axillary lymph node status, 56% with the TNM-system and 64% with a combination of TNM system and nuclear and histological grade. Morphometry thus seems possible to predict the outcome of individual patients more accurately than with the usual staging/grading methods. This technique might therefore prove to be useful in the selection of patients for adjuvant chemotherapy.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1365-2559
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Discrimination between borderline and malignant mucinous ovarian tumours is a well-known diagnostic problem. In order to obtain objective reproducible and consistent features for differential diagnosis, 32 quantitative microscopical features were assessed in 10 benign, 10 borderline and 22 malignant mucinous ovarian tumours. There were many significant differences between the three groups, but using multivariate analysis there was 93% agreement between the histopathological assessment of these sections and the qualitative analyses. The following features were useful in the quantitative classification: the mean area, the mean perimeter and the mean of the short axis of the nucleus; the volume percentage of the epithelium; the mitotic activity. In three cases, there was a difference between the original histopathological and computer classification. It was debatable whether the original diagnosis was correct, and therefore, all the cases were independently reassessed blind by three pathologists. Their diagnoses lend strong support to the computer classification in two of the three cases. The computer classification seems therefore to be even better than 93%. The present quantitative techniques are inexpensive, relatively easy to use, and, we believe, have a useful place in diagnostic histopathology.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1365-2559
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: There are many significant differences, but also considerable overlap between the quantitative histopathological features of mild and marked atypical endometrial hyperplasias and well and moderately differentiated carcinomas, thus preventing its application to individual patient care. To try to overcome this problem, a classification rule for the diagnosis in individual patients, using discriminant analysis has been developed. Utilizing nine quantitative features, all the above four groups can be adequately separated. None of the carcinomas was misclassified as hyperplasia, and only one case of marked atypical hyperplasia was erroneously classified as well differentiated carcinoma, but with a probability of carcinoma 0.75, hyperplasia 0.25. By contrast, the classification probabilities of all the confirmed carcinomas exceeded 0.90. Therefore, using 0.90 as a classification level (‘threshold’), a reliable rule is obtained. A slightly more simple classification rule distinguishes between all the hyperplasias and all the carcinomas. In this way, all the cases of the test set were correctly classified. The classification rules can be used to select patients with benign disease for hormone therapy(Kistner 1973) as an alternative to hysterectomy, and can be programmed in an inexpensive microcomputer. The quantitative techniques are relatively easy, and are capable of being performed in most histopathological laboratories.
    Type of Medium: Electronic Resource
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