[1217] Morphometric Analysis in the Distinction between Invasive and In Situ Endocervical Adenocarcinoma

Carlos Parra-Herran, Tyna Hope, Sharon Nofech-Mozes, Taha Rashed, Guangming Han, Elzbieta Slodkowska, Fang-I Lu, Nadia Ismiil, Mahmoud Khalifa, Gina Clarke, Martin Yaffe, Matthew Cesari. Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Centre for Imaging Technology Commercialization, Toronto, ON, Canada

Background: Morphologic distinction between in situ (ACIS) and invasive (INVA) endocervical adenocarcinoma, while having important clinical implications, can be challenging. As diagnostic digital pathology gains momentum, we aimed to identify quantifiable histologic features by digital image analysis that can differentiate between ACIS and INVA, which may be used as an adjunct diagnostic tool.
Design: Scanned images of 7 cases of ACIS and 7 cases of INVA in cone or hysterectomy specimens were included. Representative glands (2-4) were selected from each case and analyzed using Mercator Version 1.0 (ExploraNova, La Rochelle, France). The system detects structures based on optical density and analyzes them as closed objects. We collected morphometric variables in glands and periglandular stroma. Non-parametric Wilcoxon Mann Whitney test was used to evaluate the difference between both groups.

Table 1. Morphometric variables in ACIS and INVA
GLANDSNuclear densityNC/TSA0.33
 Mean nuclear form factor (MNFF)SNF/NC0.18
 % Nuclear surface areaSNA/TSA*1000.75
STROMANuclear density (ND)NC/TSA0.85
 Mean nuclear form factor (MNFF)SNF/NC0.009
 % Nuclear surface areaSNA/TSA*1000.48
 % Collagen surface areaSCoA/TSA*1000.02
NC = Nuclear count, TSA = Total Region Surface Area, SNF=Sum of nuclear form factors, SNA = Sum of all nuclear areas, SCoA = Sum of all collagen areas. All areas in µm2.

Results: Parameters related to nuclear density, as well as nuclear size and cytoplasmic size in both glands and stroma showed no significant difference. However, analysis of the periglandular stroma revealed that INVA had a greater mean nuclear form factor (0.372 vs 0.208, p=0.009) and lower % of collagen per region (2.82 vs 5.04, p=0.02) than ACIS.
Conclusions: Glandular cell density and cell size are similar between INVA and ACIS. However, features of the periglandular stroma, such as the nuclear contour of stromal elements (eg. fibroblasts) and the amount of collagen appear to be significantly different. This findings correlate with the standard qualitative criteria conventionally used, and underscore the potential of measurable variables using image analysis as an adjunct diagnostic tool.
Category: Gynecologic & Obstetrics

Wednesday, March 6, 2013 1:00 PM

Poster Session VI # 185, Wednesday Afternoon


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