[Quantitative study on esophageal cytology. I. Quantitative morphologic studies of normal, dysplastic and malignant...

On cytosmears of esophageal epithelium of individuals from high-risk area of esophageal cancer squamous epithelial cells, according to standard cytologic diagnostic criteria, can be categorized as normal, hyperplasia, severely dysplastic grade I and grade II, nearly-carcinoma and early carcinoma. Cytosmears from 60 patients, 10 for each category, were studied with a semiautomatic image analysis system. Thirteen morphologic parameters so obtained were further analyzed by computer-based stepwise regression and linear correlation analyses. The results showed that the following 5 parameters could be used to judge the nature of the cells, i.e. a) cytoplasmic area, b) cytoplasmic mean diameter, c) cytoplasmic form factor, d) nuclear form factor and e) N/C ratio. Comparing with cells of the other categories, values of the first 4 parameters for early cancer cells were decreased whereas that of the fifth parameter was significantly increased. From normal to hyperplastic and to dysplastic cells, the nuclear area and mean nuclear diameter were gradually increasing. Therefore, they were the major parameters in judging the degree of hyperplasia and dysplasia. These numerical features of morphologic quantitation conformed with the cytologic diagnostic criteria for cancer, hyperplasia and dysplasia under light microscope. It indicates that visual judgement is relatively accurate and application of the ocular micrometer to measure the cells would make this grading more objective.