The importance of morphometric parameters in differentiating benign/reactive urothelial cells from low-grade urothelial carcinoma: computer-assisted study on urine specimens

Background. Urine cytology is deemed a sensitive method in detection of high-grade urothelial carcinoma. In contrast, detection of low-grade urothelial carcinoma (LGUC) and its differentiation from reactive lesions is difficult with urinary cytology. Objective. Our study aims to determine the effectiveness of morphometric parameters in differentiating reactive urothelial cells from LGUC by cytological examination of urine specimens. Methods. Voided urine samples were used for the study, while the cases were randomized into two groups: those diagnosed with LGUC (first group; N=10) and those which were not diagnosed with LGUC (second group; N=10). The morphometric parameters of major nuclear diameter (MaND), minor nuclear diameter (MiND), mean nuclear area (MNA), cell diameter (CD), mean cell area (MCA), as well as MaND/CD, MiND/CD, MiND/MaND and MNA/MCA ratios were measured on 100 urothelial cells for each case through ScopeImage® 9.0 software. Results. A statistically significant difference was found between the mean values of MiND/CD (p=0.017) and MNA/MCA (p=0.002) ratios of groups. The mean value of both parameters in the first group constituted 0.2 and higher, and below 0.2 in the second group. Conclusion. The ratios of MiND/CD and MNA/MCA in urothelial cells proved significantly higher in patients with LGUC than benign/reactive cases. The reliability of these findings in differentiating LGUC from benign/reactive lesions needs to be verified through studies examining a large number of cases. These parameters can be assessed much faster through a special software enabling an automatic measurement and thus can be used in routine cytological examination.

Nuclear Morphometry as an Adjunct to Cytomorphology in the Diagnosis of Thyroid Lesions

Introduction: Fine Needle Aspiration Cytology (FNAC) is a reliable and reproducible diagnostic technique for thyroid lesions. Recently, it has been suggested that evaluation of nuclear features may enhance the diagnostic utility of FNAC. However, the evaluation of nuclear morphometry is not well established in thyroid cytology. Aim: To evaluate the role of nuclear morphometry in cytological evaluation of thyroid lesions. Materials and Methods: This was a cross-sectional study conducted over a period from March 2019-February 2020 at Hamdard Institute of Medical Sciences and Research, New Delhi, India. Morphometry was done on 40 cases of thyroid aspirates which had histopathological concordance. Computerised nuclear morphometry was done by using photographs captured under Motic photomicrography system. Six parameters were measured- nuclear area, nuclear perimeter, minimal nuclear diameter, maximal nuclear diameter, nuclear compactness and LS ratio (Largest to Smallest dimension ratio). Data were entered in spreadsheet and then analysed using Statistical Package for Social Sciences (SPSS) version 20.0. Results: Out of total 40 thyroid aspirates studied, included non neoplastic (19 cases), benign (12 cases) and malignant lesions (9 cases). All nuclear morphometry parameters comprising of nuclear area, nuclear perimeter, minimal nuclear diameter, maximal nuclear diameter showed an increasing trend from non neoplastic to benign to malignant with a statistically significant difference between benign and malignant groups (p-values <0.05) except for LS ratio and nuclear compactness. Conclusion: Nuclear morphometry can aid in cytological diagnosis of thyroid lesions. If used judiciously, quantitative estimation of cytological nuclear features can be helpful in assessing thyroid lesions preoperatively thus complementing its cytomorphological features.

Quantitative Morphology as a Prognostic Factor in Feline Spontaneous Cutaneous Squamous Cell Carcinomas

In a study on cytological specimens from 30 cats with histologically confi rmed cutaneous squamous cell carcinoma, the morphometric variables mean nuclear area (MNA, μm2), mean nuclear perimeter (MNP, μm), mean nuclear diameter (D mean, μm), minimum nuclear diameter (D min, μm) and maximum nuclear diameter (D max, μm) were studied and compared to metastases in regional lymph nodes. The mean values of these parameters were signifi cantly greater in cats with lymph node metastases compared to parameters of tumour cells from cats which were lymph node-negative. A signifi cant positive correlation was observed between all studied morphometric parameters and metastases in the regional lymph nodes. In conclusion, computer -assisted nuclear morphometry could be used as a prognostic method in the diagnosis of spontaneous feline cutaneous squamous cell carcinomas.

The value of rapid semi-automated morphometric analysis system in predicting malignancy in thyroid follicular neoplasm

To constuct and evaluate a rapid semiautomated system in discriminating malignant from benign follicular thyroid neoplasms.Sixty formalin fixed paraffin embeded blocksof follicular thyroid neoplasms were retreived and slides were prepared and H and E stained. A morphometric system was constructed to be as rapid as possible and was tested. No signficant difference was found in ratio of largest nuclear to smallest nuclear diameter between follicualr adenoma and follicualr carcinoma groups. Rapid semiautomated morphometric analysis is of no help in predicting malignancy in follicular thyroid neoplasm.

Detection of Cytomorphological Changes in Buccal Mucosal Cells of Type 2 Diabetic Patients Using Oral Exfoliative Cytology

Background: Diabetes mellitus is an extremely common endocrine metabolic disorder that results in chronic hyperglycemia. It has effects on various tissues of the body. Due to this increased blood glucose levels considerable cellular changes occur in oral cavity as well. This field has attracted little research. The aim of the study was to analyze the changes in morphology and cytomorphometric measurements in the buccal mucosal cells of type 2 diabetic patients.Objectives: The Objective of this study was to detect the cytological and morphological alterations of oral epithelial cells, in type 2 diabetic patients and healthy control subjects in exfoliated cytology smears, to com-pare the cytoplasmic diameter, nuclear diameter, and nucleus: cytoplasm ratio in type 2 diabetics and heal-thy control subjects and to analyze the above mentioned cellular alterations in patients with controlled and uncontrolled diabetes.Methods: Cross-sectional analysis was performed in three groups on the bases of HbA1c levels. Group 1 was uncontrolled diabetics with HbA1C ≥ 7.0%, Gro-up 2 was well controlled diabetics with HbA1c ≤ 7.0% and Group 3 was Control healthy having HbA1C ≤ 5. 6%. Smears from normal buccal mucosa were obtai-ned from each subject and stained with Papanicolaou method. An eyepiece micrometer was used to take mean values of ND, CyD, and N: C ratio. Fifty (50) clearly defined cells were measured in each case in a step wise manner, to evade quantifying cells once more. Comparison of Nuclear Diameter (ND), Cytoplasmic Diameter (CY D) and ratio of two Diameters (N: C) among three groups was performed by using ANOVA. TUKEY’S test for post –hoc analysis was used where required.Results: The variability in diameter of nucleus among all three sample groups showed significant p-value < 0.001.Whereas the measurement for cytoplasmic diameter between three groups was not significant (p-value 0.178). The ratio of nuclear diameter to cytoplasmic diameter calculated was significant (p-value < 0.001). Hence it proved from the results that considerably exaggerated ND and N: C ratios were seen as the glycemic control (HbA1C) is poorer.Conclusion: The results suggested that nuclear size of buccal mucosal cells increased in type 2 diabetic pati-ents while no change was observed in cytoplasmic dimensions.

Cytomorphometry of serosal effusion in dogs

Cytomorphometry made on cytological slides is the quantitative method of precise analysis of cellular structures, including both cytoplasm and nucleus. The aim of this study was to describe cytomorphometric parameters of mesothelial cells in the course of benign reactive and malignant proliferation and to compare them to carcinomas and adenocarcinomas located within serosal cavities in dogs. The second aim was to evaluate applicability of cytomorphometry to diagnostics of diseases causing accumulation of effusion in serosal cavities. Cytological samples of normal and non-malignant mesothelium, mesothelioma and various carcinomas were collected from dogs. Cytomorphometry was made on the smears stained with Giemsa solution. Mean nuclear and cellular perimeter, mean nuclear and cellular area, mean nuclear and cellular diameter, and mean nuclear and cellular roundness were determined. Moreover, nuclear to cytoplasmic ratio (N/C) was calculated. The data revealed statistically significant differences for all parameters, excluding mean nuclear perimeter, between compared groups. Normal mesothelium cells and their nuclei were significantly smaller and more elongated than cells and nuclei of both benign reactive and malignant neoplastic mesothelium. Only a few differences were observed between benign reactive mesothelium cells and mesothelioma cells – mean nuclear area and mean nuclear diameter of benign reactive mesothelium cells were significantly larger and N/C ratio was higher in comparison to mesothelioma cells. Even though some significant differences were observed, considerable overlap of these cytomorphometric parameters in animals with different diseases limited practical role of these observations. Cytomorphometric analysis of cellular samples collected from dogs with proliferative processes affecting serosal cavities can be only an auxiliary method increasing accuracy of preoperative diagnosis.