Discriminant Analysis of Malignant Mesothelioma and Reactive Mesothelium Using Three-Dimensional Nuclear Estimation

Abstract

Objective: The cytological diagnosis of coelomic fluid is essential for examining malignant mesothelioma (MM). However, reactive mesothelium (RM), caused by various factors, is morphologically similar to MM and thus often complicates the differential diagnosis. Here, nuclear luminance and steric alterations were assessed for the discriminant analysis of MM and RM. Study Design: Thirteen epithelial MM and 11 RM cases were included. One hundred alterations in the numbers of nuclear pixels and focus layers and the coefficient of variation of nuclear luminance among layers were determined for each case to conduct discriminant analysis using the Mahalanobis distance. Results: A cutoff value of 0.072 allowed highly accurate discrimination of MM (89.5%) and RM (89.6%). Fifteen cells appeared in 6 agglomerates of indiscriminable MM cases. The 6 agglomerates were individually examined. Malignant cells were dominant in 3 agglomerates (50%), allowing the discrimination of malignant cases. Conclusion: Discrimination using nuclear luminance and steric alterations is useful for morphologically indiscriminable MM cases. Three-dimensional analysis of agglomerates will be further investigated to improve the diagnostic accuracy.

Discriminant Analysis between Malignant Mesothelioma and Reactive Mesothelium Using Nuclear Three-Dimensional Analysis Is Useful for Morphologically Suspicious Cases

“…Our analysis was useful in discriminating between MM and RM in specimens using the auto-smear method. As reported in 2011, retrospective discriminant analysis using direct smear specimens from patients histologically diagnosed as MM or RM yielded discrimination rates of 89.5% for MM and 89.6% for RM [18]. Nuclear roundness was also examined in our discriminant analysis, which increased the discrimination rate of MM to 91.7%.…”

“…(2) Discriminant analysis of MM and RM using centrifuged direct smear specimens [18]. The discrimination between RM and MM using data (excluding roundness) obtained from auto-smear specimens in the present study, based on a cut-off value determined from direct smear specimens of 0.072, is shown in tables 5 and 6.…”

“…We focused on the 3-dimensional structures of nuclei in cell smear specimens to investigate the objective discrimination of malignancy using the 3-dimensional analysis of nuclear luminance [15,16,17,18]. Individual nuclei in cell specimens were 3-dimensionally photographed for retrospective discrimination based on Mahalanobis distance using various parameters including pixel counts (area), number of focus layers (number of images with the nuclei microscopically and morphologically focused) and 3-dimensional variation in the coefficient of variation of nuclear luminance between the focus layers (3D-CV), facilitating a discriminant diagnosis between MM and RM [18].…”

“…Individual nuclei in cell specimens were 3-dimensionally photographed for retrospective discrimination based on Mahalanobis distance using various parameters including pixel counts (area), number of focus layers (number of images with the nuclei microscopically and morphologically focused) and 3-dimensional variation in the coefficient of variation of nuclear luminance between the focus layers (3D-CV), facilitating a discriminant diagnosis between MM and RM [18]. Thus, atypical mesothelial cells were analyzed in a blinded manner with regard to the results of the discriminant diagnosis between MM and RM.…”

Significance of Binucleated Cells with Compression in Atypical Squamous Cells of Undetermined Significance

“…We focused on the 3-dimensional structures of nuclei in cell smear specimens and reported objective discrimination using 3-dimensional and discriminant analyses of nuclei [4][5][6] . The nuclei of ASC-US cases in initial cytology were 3-dimensionally analyzed using liquid-based cytology (LBC) specimens prepared by the ThinPrep method.…”