Cytomorphometric differentiation of intraductal proliferative breast lesions

Review: Proposed Methods to Improve the Survival of Adipose Tissue in Autologous Fat Grafting

In 2009, the American Society of Plastic Surgeons Task Force on Autologous Fat Grafting (AFG) determined that autologous fat grafting was a safe procedure with a relatively low rate of complications. This consensus opinion unleashed a wave of popularity as plastic surgeons discovered the procedures' efficacy in a wide variety of cosmetic and reconstructive indications. Frequently reported cosmetic applications include soft-tissue augmentation of breast, buttocks, hips, face, and hands, whereas reconstructive applications include adjunct for breast reconstruction contour problems, plantar fat pad improvement, and correction of various posttraumatic and surgical contour deformities. Recognition of other regenerative effects of fat grafting expanded the use AFG for improvement of hypertrophic scar tissue, postradiation sequelae, lipodystrophy, hyperpigmentation, senile skin changes, and actinic damage. The popularity of AFG is supported by a remarkably low risk of complications, minimal scars, and readily available donor sites. Despite recognition of the advantages of AFG, there still is no consensus regarding optimal techniques of harvest, graft preparation, and injection. Further, the yield of permanent volume falls within a very wide range. In this article, we review the basic science of fat grafting, proposed methods offered to improve engraftment, and reported outcomes of AFG procedures.

Immunohistochemical quantification of expression of a tight junction protein, claudin-7, in human lung cancer samples using digital image analysis method

BACKGROUND AND OBJECTIVES

Tight junction proteins are correlated with cancer development. As the pivotal proteins in epithelial cells, altered expression and distribution of different claudins have been reported in a wide variety of human malignancies. We have previously reported that claudin-7 was strongly expressed in benign bronchial epithelial cells at the cell-cell junction while expression of claudin-7 was either altered with discontinued weak expression or completely absent in lung cancers. Based on these results, we continued working on the expression pattern of claudin-7 and its relationship with lung cancer development. We herein proposed a new Digital Image Classification, Fragmentation index, Morphological analysis (DICFM) method for differentiating the normal lung tissues and lung cancer tissues based on the claudin-7 immunohistochemical staining.

METHODS

Seventy-seven lung cancer samples were obtained from the Second Affiliated Hospital of Zhejiang University and claudin-7 immunohistochemical staining was performed. Based on C++ and Open Source Computer Vision Library (OpenCV, version 2.4.4), the DICFM processing module was developed. Intensity and fragmentation of claudin-7 expression, as well as the morphological parameters of nuclei were calculated. Evaluation of results was performed using Receiver Operator Characteristic (ROC) analysis.

RESULTS

Agreement between these computational results and the results obtained by two pathologists was demonstrated. The intensity of claudin-7 expression was significantly decreased while the fragmentation was significantly increased in the lung cancer tissues compared to the normal lung tissues and the intensity was strongly positively associated with the differentiation of lung cancer cells. Moreover, the perimeters of the nuclei of lung cancer cells were significantly greater than that of the normal lung cells, while the parameters of area and circularity revealed no statistical significance.

CONCLUSIONS

Taken together, our DICFM approach may be applied as an appropriate approach to quantify the immunohistochemical staining of claudin-7 on the cell membrane and claudin-7 may serve as a marker for identification of lung cancer.

Applicability of preoperative nuclear morphometry to evaluating risk for cervical lymph node metastasis in oral squamous cell carcinoma

BACKGROUND

We previously reported the utility of preoperative nuclear morphometry for evaluating risk for cervical lymph node metastases in tongue squamous cell carcinoma. The risk for lymph node metastasis in oral squamous cell carcinoma, however, is known to differ depending on the anatomical site of the primary tumor, such as the tongue, gingiva, mouth floor, and buccal mucosa. In this study, we evaluated the applicability of this morphometric technique to evaluating the risk for cervical lymph node metastasis in oral squamous cell carcinoma.

METHODS

A digital image system was used to measure the mean nuclear area, mean nuclear perimeter, nuclear circular rate, ratio of nuclear length to width (aspect ratio), and nuclear area coefficient of variation (NACV). Relationships between these parameters and nodal status were evaluated by t-test and logistic regression analysis.

RESULTS

Eighty-eight cases of squamous cell carcinoma (52 of the tongue, 25 of the gingiva, 4 of the buccal mucosa, and 7 of the mouth floor) were included: 46 with positive node classification and 42 with negative node classification. Nuclear area and perimeter were significantly larger in node-positive cases than in node-negative cases; however, there were no significant differences in circular rate, aspect ratio, or NACV. We derived two risk models based on the results of multivariate analysis: Model 1, which identified age and mean nuclear area and Model 2, which identified age and mean nuclear perimeter. It should be noted that primary tumor site was not associated the pN-positive status. There were no significant differences in pathological nodal status by aspect ratio, NACV, or primary tumor site.

CONCLUSION

Our method of preoperative nuclear morphometry may contribute valuable information to evaluations of the risk for lymph node metastasis in oral squamous cell carcinoma.

Histopathological change of oral malignant tumour and epithelial dysplasia subjected to photodynamic therapy

Objectives

The purpose of this study is to analyze the morphological change of cell nuclei and the change of proliferating activity of oral malignancy and epithelial dysplasia between before and after photodynamic therapy in order to predict recurrence.

Material and methods

We experienced 14 cases of oral squamous cell carcinoma, one case of verrucous carcinoma and seven cases of epithelial dysplasia treated by photodynamic therapy (PDT). The mean nuclear area (NA) and coefficient of variation of the nuclear area (NACV) of 100 nuclei per slide were calculated using computer-assisted image analysis in hematoxylin and eosin stained biopsy specimens before and after PDT. Additionally, proliferating cell nuclear antigen (PCNA) immunohistochemistry was carried out in each specimen.

Results

The mean NA after PDT was significantly lower than that before PDT in the nonrecurrent group. However, there was no significant difference in mean NA before and after PDT in the recurrent group. There were no significance differences in NACV before and after PDT in either the nonrecurrent or recurrent group. Furthermore, the PCNA labelling indices of the specimens after PDT was significantly lower than that before PDT in both the nonrecurrent and the recurrent group.

Conclusions

Mean nuclear area in the biopsy specimen after photodynamic therapy is likely to be a predictive marker for the recurrence of oral squamous cell carcinoma or epithelial dysplasia subjected to photodynamic therapy, while coefficient of variation of the nuclear area and proliferating cell nuclear antigen labelling indices are less helpful in predicting the recurrence of such lesions.

Morphometric analysis of mouse tumor nuclei subjected to photodynamic therapy

PURPOSE

The diachronic changes in nuclei in tumor cells subjected to photodynamic therapy (PDT) were investigated using computer assisted analysis to elucidate the degeneration process of tumor cell nuclei.

MATERIALS AND METHODS

A photosensitizer was injected intraperitoneally to mice bearing NR-S1 mouse squamous cell carcinoma in the dorsum 48 hours before laser irradiation. Mice were sacrificed at intervals of 0, 0.5, 1.5, 2.5, 6, 24, 48, and 72 hours after PDT, and tumors were excised. Neither photosensitizer nor laser irradiation was administered to control mice. A 4-mum section was prepared from each specimen, followed by hematoxylin and eosin staining. The nuclei of the tumor cells were examined under a light microscope. The mean nuclear area and coefficient of variation of the nuclear area of 100 nuclei per slide were calculated.

RESULTS

Both nuclear area and coefficient of variation of the nuclear area were significantly lower in the experimental groups nuclei than in control mouse nuclei at 24 and 48 hours after PDT.

CONCLUSION

These results suggest that maximum damage to tumor nuclei occurs between 24 to 48 hours after PDT.

Predictability of lymph node metastases by preoperative nuclear morphometry in squamous cell carcinoma of the tongue

AIM

This study was undertaken to assess the predictability of lymph node metastases by analyzing preoperative nuclear morphometry of squamous cell carcinoma of the tongue.

METHODS

Twenty-eight cases of well-differentiated squamous cell carcinoma (13 cases with metastasized lymph nodes, 15 node-negative cases) were examined. Using a computerized image system, the mean nuclear area, the nuclear perimeter, the circular rate, the largest to the smallest dimension ratio (LS ratio) of the nuclei, and the coefficient of variation of the nuclear area (NACV) were measured. The relationship between these results and the lymph node involved was evaluated retrospectively.

RESULTS

The nuclear area and perimeter were significantly higher in cases with metastasized lymph nodes than in node-negative cases (P<0.05). The circular rate was also higher in cases with no metastasized lymph nodes than in node-positive cases (P<0.05). The LS ratio was higher in cases with metastasized lymph nodes than in node-negative cases (P=0.072). The NACV value was also higher in cases with metastasized lymph nodes than in node-positive cases, which showed no significant differences (P=0.322).

CONCLUSIONS

Preoperative quantitative estimations of nuclear features could provide a feasible criterion for the prediction of lymph node metastases in squamous cell carcinoma of the tongue.