Dysplastic epithelial changes as a sequence of binary event in gastric pathology

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Abstract

A simple, semiquantitative method for evaluation of epithelial and glandular changes in gastric hyperplastic lesions is presented. The differences of morphological features of the neighboured cells are denoted as the twenty-elements series of binary digits (0 or 1). The study was carried out in 89 gastric biopsy specimens divided qualitatively into five diagnostic groups (Jarvis and Whitehead classification) 1) no hyperplastic changes 2) low grade dysplasia, 3) moderate dysplasia, 4) severe dysplasia and 5) highly differentiated carcinoma. The following cytomorphological features were assessed semiquantitively in glandular epithelia: differences in The shape of the nuclei, differences in the size of the nuclei and in the position of the nuclei, differences in the axial direction of the nuclei as well as the differences in gland shapes. The resulting data were in the form of "percent of changes'' for each case and each feature. To evaluate the usefulness in such kind of data ANOVA, Kruskall-Wallis nonparametric ANOVA, Mann-Whitney test and multiple regression analysis were performed. Intra- and interobserver variability was also assessed. We concluded that our simple method gives comparable and reproducible results. All applied statistical methods gave similar results. The most "discriminating" cell features were: position of the nucleus in the cell, size and shape of the nucleus and loss of nuclear polarization. Significant differences were found between the control group and low grade dysplasia and between high grade dysplasia and carcinoma.

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Over : Robert Koktysz

Over : Krzysztof W. Zieliňski