Correlation of Nuclear Morphometry with Clinicopathologic Parameters in Malignant Breast Aspirates

Background Nuclear size, shape, chromatin pattern, and nucleolar size and number have all been reported to change in breast cancer. Aim The aim of the study was to quantify nuclear changes on malignant breast aspirates using morphometry and to correlate the morphometric parameters with clinicopathologic features such as cytologic grade, tumor size, lymph node status, mitotic index, and histopathologic grade. Materials and Methods Forty-five cases of carcinoma breast diagnosed on cytology were included in this study. Cytologic grading was performed as per the Robinson’s cytologic grading system. Nuclear morphometry was done on Papanicolaou stained smears. One hundred nonoverlapping cells per case were evaluated. Both geometrical and textural parameters were evaluated. Results Comparison of cytologic grades with most morphometric features (nuclear area, perimeter, shape, long axis, short axis, intensity, total run length, and TI homogeneity) was highly significant on statistical analysis. Correlation with tumor size yielded significant results for nuclear area, perimeter, long and short axes, and intensity with p < 0.05. The study of lymph node status and morphometry showed a highly significant statistical association with all the parameters. Mitotic count was significantly associated with all the geometric parameters and one textural parameter (total run length). On correlation of ductal carcinoma in situ and histopathological Grades 1 to 3 with morphometry, it was found that all the parameters except long–run emphasis were highly significant with p < 0.001. Conclusion Morphometry as a technique holds immense promise in prognostication in breast carcinoma.

Nuclear Morphometry is a superior Prognostic Predictor in comparison to Histological grading in Renal cell Carcinoma: A Retrospective Clinico-pathological study

Background: Renal cell carcinoma (RCC) comprises of a spectrum of clinico-pathologically distinct entities thereby making it difficult to accurately predict the clinical outcome. Though many predictive factors have been described in literature, tumor stage and nuclear grade have been established to consistently correlate with the tumor behaviour. However, tumors in the same stage have shown to behave differently. Similarly subjectivity and lack of reproducibility in nuclear grade mandates use of more objective parameters such as digital nuclear morphometry which could provide consistent and more reliable results in predicting prognosis. The study was conducted with the main objective of comparing the histological grade and the nuclear morphometric variables in RCC for predicting the clinical outcome. Material and methods: A total of 219 cases of renal tumors in adults were retrieved retrospectively from the archives of pathology department in Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow and their clinical, gross and microscopic features were noted. Nuclear grading was done in 181 cases of clear cell and papillary RCC of which computer-assisted morphometry for various nuclear parameters was done in 100 cases where a follow-up data of at least 3 years was available. Nuclear grade and morphometric parameters were correlated statistically with the clinical outcome of the patients. Results: Histological nuclear grade did not show statistically significant correlation with progression free survival (PFS). Higher values of mean nuclear area, mean nuclear circumference, mean nuclear major diameter and mean nuclear minor diameter were significant predictors of PFS with a strong inverse correlation. Conclusion: Nuclear morphometry is a more reliable predictor of clinical outcome in patients of RCC when compared to histological grade and should be included in predictive model with other clinical and pathological parameters to accurately determine tumor behaviour

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.

Nuclear morphometry of mammary tumors of dogs and histopathological diagnosis

For dog’s mammary tumors diagnostics scientists need researches, which can adopt and use methods developed for humans. The aim of this research paper is to set the inter relation between the parameters of nuclear morphometry (nuclear area, diameter, perimeter) and histopathological type of mammary tumors of dogs. Animals aged from 6 to 12 (medium meaning 9.2 ± 1.6 years). According to histopathological research 3 tumors were benign and 25 were malignant, 18 of them – malignant epithelial neoplasms (3 tubular carcinomas, 13 tubulopapillary carcinomas, 1 cystic-papillary carcinoma, 3 colid carcinomas, 1 micropapillary carcinoma), 3 malignant epithelial neoplasms of special type (mucinous, lipid-rich, spindle cell carcinomas) and 4 malignant mesenchymal neoplasms (chondrosarcoma). Nuclear morphometry parameters (nuclear area, perimeter and diameter) of benign tumours (20.48 ± 1.22, 19.13–21.50 µm2; 19.27 ± 0.10, 19.17–19.36 µm and 5.09 ± 0.16, 4.92–5.22 µm) were probably smaller than in malignant tumours, for example in simple carcinoma (38.61 ± 5.61, 29.26–46.16 µm2; 26.42 ± 2.32, 22.10–29.60 µm and 6.96 ± 0.52, 6.03–7.62 µm), tubular (37.89 ± 7.30, 29.94–46.16 µm2, 26.34 ± 2.83, 22,98–29,60 µm and 6.90 ± 0.70, 6.16–7.62 µm), tubulopapillary (40.22 ± 3.48, 34.38–44.75 µm2, 27.02 ± 1.49, 24.41–28.97 µm and 7.12 ± 0.31, 6.58–7.52 µm), colid (43.57 ± 5.54, 37.71–48.73 µm2, 28.05 ± 1.88, 26.54–30.15 µm and 7.41 ± 0.47, 6.91–7.85 µm), other malignant epithelial neoplasms (39.99 ± 5.15, 29.94–48.73 µm2; 26.85 ± 2.03, 22.98–30.15 µm and 7.09 ± 0.50, 6.16–7.85 µm) and malignant epithelial neoplasms of special types (45.89 ± 4.12, 43.41–50.65 µm2; 29.92 ± 0.21, 29.68–30.06 µm and 7.60 ± 0.34, 7.41–8.00 µm). However, there was not statistically significant difference in comparison between benign tumours and sarcomas (25.95 ± 5.21, 21.64–33.00 µm2; 21.85 ± 1.79, 20.21–24.05 µm and 5.68 ± 0.56, 5.21–6.42 µm). Among the different groups of malignant neoplasms lower rates were in sarcoma, the other groups had no difference. Taking into consideration the indicators of nuclear morphometry (nuclear area, diameter and perimeter) different types of neoplasms can be differentiated: benign from malignant tumours and sarcomas from malignant epithelial neoplasms (tubular, tubulopapillary, cystic-papillary, colid, micropapillary, mucinous, lipid-rich and spindle cell carcinomas).