A model for quantitative follow‐up studies of cervical lesions

Abstract

A model for follow-up studies of cervical lesions is described in which the specimen were taken in a noninvasive way using Cytobrushes and in which automatic measurement of the abnormal nuclei in the sampled epithelial fragments was possible because 2-microns thin Feulgen-stained plastic sections were prepared. The planimetric parameters AREA, PERIMETER, FORM PE, and FORM ELL, and the densitometric parameters optical density (OD) and integrated optical density (IOD) were assessed. The mean total volume and the mean total DNA were calculated using stereological methods. The moderate dysplasias differed from the carcinoma in situs for all the densitometric parameters except for OD, and from the invasive carcinomas for IOD and 5cER. In the moderate-dysplasia group, there were three types of DNA histograms: a highly abnormal type resembling the histograms of the carcinoma group, a normal type, and an intermediate type. Changes in DNA histograms can be established during follow-up studies of dysplasias without having disturbed the lesion due to the efficient and elegant noninvasive sampling method that was not used in earlier quantitative studies.

Application of Plastic Embedding to Fine Needle Aspiration Biopsy

“…As reported, very slight alterations in nuclear shape were easily observed because the sections are thin. 5,17 Moreover, because of the relative hypochromasia, changes in chromatin pattern were easily observed. The cytoplasm generally appears pale or completely clear and intranuclear inclusions prominently visible.…”

“…16,17 Comparing the thin sections to the smears, the nuclei available to be measured were generally less numerous in the sections than in the smears; nonetheless, the absence of nuclear overlapping, the perfect focal plane and concentration of the nuclei in a small area of the slide facilitated measurements on the sections. In fact, a comparison of these histograms obtained with those from the corresponding Feulgen-stained smears was consistent.…”

“…Therefore, to solve the problem of dense epithelial fragments and to perform multiple techniques from the same FNAB specimen, we turned to plastic embedding of aspirated material. 5,6,14,16,17 This technique has been successfully utilized to solve the problem of celldense groups dislodged by the cervical Cytobrush, 5 for quantitative studies of cervical and urothelial neoplasms 14,16,17 and for the immunophenotypic study of hematopoietic and lymphoid tissue. 5 The aim of this study was to explore the possible advantages that plastic embedding techniques may offer, capitalizing on the material available and utilizing thin plastic sections for quantitative and immunocytochemical studies.…”

“…8,17,18 For determination of the 2C value, the integrated optical density (IOD) of 20 lymphocytes was measured on each slide. The…”