Discrimination of pancreatic adenocarcinomas from chronic pancreatitis by morphometric analysis

Chronic pancreatitis and pancreatic ductal adenocarcinoma show similar gross and microscopic anatomical features. Morphological examination alone is not always sufficient in diagnostic practice to make the clinically important discrimination between these two entities. Cases of pancreatic tumors were analysed in a morphometric study to evaluate the discriminatory value of nuclear and nucleolar features. Histologic sections of pancreas from 18 cases of chronic pancreatitis and 33 cases of ductal adenocarcinoma were included either into a learning or a test set. A multivariable discriminatory rule was derived from the learning set of 23 cases including nuclear polymorphism and nucleolar density. When applied to the test set, all 28 cases of adenocarcinomas and chronic pancreatitis were correctly classified. Distributional features describing nucleolar density and variation in nuclear size and shape were the most efficient discriminatory variables. Morphometry is shown to be a simple and fast cell analytical method which can support clinical judgement in distinguishing between chronic pancreatitis and pancreatic ductal adenocarcinoma.