细胞图像分析预测食管上皮增生转归的研究  

Prediction of the outcome of dysplasia of esophageal epithelium by high resolution image analysis

作　　者：周彬[1] 丁镇伟[1] 郭黎平[1] 潘秦镜[1] 高峰[1] 王继信[1] 林培中[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤研究所肿瘤医院,北京100021

出　　处：《中华肿瘤杂志》1999年第6期439-443,共5页Chinese Journal of Oncology

摘　　要：目的　探讨食管癌前期病变细胞核的染色质特征与癌变的关系,并对其癌变进行早期预测。方法　标本取自1983 年林县河顺乡食管细胞学普查。鳞状上皮重度增生93 例,轻度增生122例。所有标本均为食管拉网涂片,巴氏染色。图像输入设备是Axiomat 图像分析系统,由VAX4000500计算机控制,idl 软件。每一样本随机选择100 以上保存完好的鳞状上皮中层细胞,用100 ×物镜进行细胞核的测量。结果　从100 多个染色质形态、光密度和纹理的特征中,选出15 个有意义的特征进行判断。93 例重度增生3 年、5 年和9 年后癌变的病例作为高分辨率细胞分析样本,细胞图像分析判断为癌变的分别为18 例、12 例和6 例,判断正确率分别为75 .0 % (18/24) 、85 .7 % (12/14) 和85 .7 % (6/7) ;122 例轻度增生3 年、5 年和9 年后癌变的病例,细胞图像分析判断为癌变的分别为15 例、10 例和10 例,判断正确率分别为93 .8 % (15/16) 、76 .9 % (10/13) 和83 .3 % (10/12) 。结论　利用高分辨率细胞图像分析系统提取细胞核的特征能够区别癌变组和非癌变组,并可对癌前病变进行癌变的早期预测,在肿瘤预防研究中可以作为代用终期生物学指标之一。Objective To predict the outcome of dysplasia of esophageal epithelium by means of high resolution image analysis(HRIA).Methods Asymptomatic adults were examined for balloon cytology of the esophagus in 1983 from Heshun Commune of Linxian County. Ninety three cases of severe dysplasia and 122 cases of mild dysplasia of the esophagus were selected for this study. By means of an Axiomat microscope equipped with TV camera, 100 normal nuclei of well preserved cells in the intermediate layer of Pap stained squamous epithelium were randomly examined.Results Of the 93 cytologically diagnosed severe dysplasia cases, 24, 14 and 7 progressed to carcinoma in 3, 5 and 9 years, respectively. In the other 48 cases, dysplasia remained stable or regressed to normal. The other cases were used as the control. According to chromatin features, correct diagnosis of cases was achieved by HRIA in 75.0%(18/24), 85.7%(12/14) and 85.7%(6/7) of the cases examined, respectively ( P <0.001). Of the 122 cytologically diagnosed mild dysplasia, 16, 13 and 12 cases progressed to carcinoma in 3, 5 and 9 years, respectively. The other 81 cases remained stable or regressed to normal. Correct diagnosis was made by HRIA in 93.8%(15/16), 76.9%(10/13) and 83.3%(10/12) of the cases examined, respectively ( P <0.001).Conclusion Chromatin nuclear features examined by HRIA can predict the outcome of precancerous lesions and discriminate progressor from non progressor ones. It can be used as surrogate endpoint biomarkers for the evaluation of efficiacy of chemoprevention trial.

关 键 词：食管肿瘤 癌前病变 细胞图像分析 食管上皮增生 

分 类 号：R735.104[医药卫生—肿瘤]