1.Computer-linked image analysis of nuclear area: is there a use in diagnosis and grading of hepatocellular carcinoma?
Phaik-Leng Cheah ; Lai-Meng Looi
The Malaysian journal of pathology 2007;29(1):37-40
Hepatocellular carcinoma (HCC) ranks as the fifth most common cancer with an increasing frequency worldwide. "Nuclear atypia", one of the critical features in histological diagnosis of malignancy and grading of the tumour, is generally ascertained through eyeballing. A study was conducted at the Department of Pathology, University of Malaya Medical Centre to assess whether nuclear area, (surrogate measure for nuclear size) and standard deviation (surrogate measure for nuclear pleomorphism) when objectively measured via computer-linked image analysis differs between (1) benign and malignant liver cells and (2) different grades of HCC. A 4-microm thick H&E stained section of 52 histologically re-confirmed HCC with 36 having benign, non-dysplastic surrounding liver were analysed using the Leica Q550 CW system. 10 consecutive non-overlapping, non-mitotic and non-apoptotic nuclei of HCC and surrounding benign hepatocytes respectively were manually traced at 400x magnification on the computer monitor and the nuclear area for the particular cell computed in arbitrary units by the Leica QWIN software. A total of 360 benign hepatocytic nuclei, 240 low grade HCC and 280 high grade HCC nuclei were traced. The mean nuclear area of the benign hepatocytes (37.3) was significantly smaller (p < 0.05) than that of both low grade (65.2) and high grade HCC (80.0). In addition, the mean nuclear area of high grade HCC was significantly larger (p < 0.05) than the low grade HCC. SD of the nuclear areas was lowest in benign hepatocytes (9.3), intermediate in low grade HCC (25.0) and highest in high grade HCC (25.6). These findings indicate that computer-linked nuclear measurement may be a useful adjunct in differentiating benign from malignant hepatocytes, in particular in small biopsies of well-differentiated tumours, and in predicting survival after surgical resection and transplant.
Grade
;
Benign
;
Computers
;
Malignant Neoplasms
;
Cancer cells grading system
2.Meningioma: A clinicopathological evaluation
Nasrin Samadi ; Seyed Ali Ahmadi
Malaysian Journal of Medical Sciences 2007;14(1):46-52
As yet no unifying grading system for meningiomas has been adopted. We evaluate epidemiologic factors of meningioma in Iran & degree of agreement between the two commonly used grading systems namely WHO (2000) and Mahmood systems. During a 6-year period 238 meningiomas were selected and reviewed by two independent pathologists using both grading systems. 205(86.1%) cases were benign, 19(8%) atypical and 14(5.9%) malignant. 181(18%) cases were primary and 51(27%) secondary; 35(68%) of the latter benign, 7(14%) atypical and 9(18%) malignant. All intraspinal meningiomas were benign. In benign cranial and spinal types female to male ratios were 1.9: 1 and 1.3: 1 ; while in atypical and malignant types were 1 :1.4 and 1:3.1 respectively. Mean ages were 49.9 for benign. 41.1 for atypical and 50 for malignant types. The most frequent site of involvement in all grades of intracranial tumors was cerebral convexity (31.1 %). The most common subtype was menigothelial (65.1%). Female preponderance seen in benign nonrecurrent meningioma became increasingly less prominent and even reversed in recurrent, atypical and malignant forms. Benign recurrent tumors were similar to non-recurrent tumors microscopically. Kappa value comparing two grading systems was 0.947, so good agreements were found between Mahmood and WHO grading systems.
Benign
;
Cancer cells grading system
;
Malignant Neoplasms
;
Meningioma
;
agreement