Scope and concepts of quantitative histopathology

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Abstract

Quantitative histopathology uses quantitative microscopy of tissues and cells for medical decisions on diagnosis and grading. The behavior of a method in the light of the diagnostic indices (sensitivity, specificity, efficiency, predictive value) is more important for the patient than the technical characteristics of the method. The variation in the methodology, and the biological relevance, determine the value of the above indices. In grading of neoplasms the performance of the tests can be estimated with the efficiency of grading after repeat experiments. Morphometric methods in diagnostic quantitative histopathology are not primarily aiming at stereologically correct interpretation, but also stereological applications are increasing, especially in research. The present expansion on computer and program development, and development of microscopic instrumentation, greatly support morphometric quantitative histopathology. Image analysis is based on the digitized microscopic image, and is also greatly dependent on the development in programs. Densitometric measurements e.g. DNA cytometry, or quantitation of immunohistochemical reactions, are typical applications. Completely automatic solutions are rare, and difficult to apply because of the great demands on laboratory performance. Flow cytometry is much used in association with histopathology because nuclei digested from paraffin embedded tissue can be studied with this method. Recent developments in molecular pathology and interphase cytogenetics have brought together quantitative histopathology and DNA hybridisation histochemistry. The prospects are that this development continues soon allowing diagnostic detection of genomic changes through microscopy.

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Over : Yrjö Collan

Over : Teijo Kuopio

Over : Kalle Alanen