Atypical Proliferative Lesions Research Articles

Nucleolar Organiser Regions in Normal, Hyperplastic, and Neoplastic Endometria

Nucleolar organiser regions (NORs) can be visualised by a silver stain that shows NOR-associated proteins as black intranuclear dots (AgNORs). NORs are loops of DNA that transcribe to ribosomal RNA, and the number of AgNORs is thought to reflect cellular proliferative activity. A study of AgNOR counts in normal, hyperplastic, and neoplastic endometria is reported. The highest AgNOR counts were found in normal proliferative endometrium and in well-differentiated endometrioid adenocarcinomas that were invading the myometrium. A mean AgNOR count of greater than 9 in curettage material from an atypical proliferative lesion of the endometrium is highly suggestive of an invasive neoplasm.

Image cytometric classification of premalignant breast disease in fine needle aspirates.

Image cytometry for the classification of fine needle aspirate (FNA) biopsies was evaluated in samples from 39 women. Eighteen of them had benign lesions, seven had premalignant lesions, nine had carcinoma in situ, and five had carcinoma. The term, premalignant, here refers to lesions with an increased risk of developing into breast cancer (atypical hyperplasia and, to a lesser extent, moderate or florid hyperplasia). The classifications by cytometry were compared with the microscopic diagnoses of the same FNA samples and of tissue from a subsequent surgical biopsy of the same area. One slide from each breast FNA sample was restained in Azure-A Feulgen. Breast epithelial cells were measured using a texture analysis program on the Leitz TAS-plus. The mean, standard deviation (SD), and interquartile range were calculated for each of 12 nuclear parameters from 200 cells per slide. A discriminant analysis was used to develop a statistical model for classifying individual samples. Six of seven atypical proliferative lesions (atypical hyperplasia and moderate hyperplasia) were identified by image cytometry, but were unrecognized by conventional microscopic examination.