Stereological Assessment of Architectural Changes in Dysplastic Epithelium of Colorectal Adenomas

Meijer, Gerrit A.; Fleege, J.C.; Baak, Jan P. A.

doi:10.1016/s0344-0338(11)80405-x

Cited by 10 publications

(7 citation statements)

References 17 publications

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“…For this reason we started to evaluate objective measures ofthe changes in dysplasia of colorectal adenomas in the present study, as well as in some previous studies. [8][9][10] Furthermore, the grading system artificially disrupts a biological continuum into three discrete classes, falsely suggesting the existence of three discrete entities. Nevertheless, subjective grading is widely used to describe the changes in dysplasia, and any new method should be compared to it.…”

Section: Resultsmentioning

confidence: 99%

Quantification of proliferative activity in colorectal adenomas by mitotic counts: relationship to degree of dysplasia and histological type.

Meijer

Baak

1995

Journal of Clinical Pathology

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Aim-Proliferative activity of tumours reflects their malignant potential. In colorectal adenomas, a subjective impression of the number of mitoses is a criterion often used to assess the degree ofdysplasia. Since these subjective impressions of mitotic activity may lack reproducibility, the aim of this study was to perform an objective analysis. Methods-Mitotic counts were conducted in tissue sections of 59 colorectal adenomas. Ofthese, 20 showed mild, 20 moderate, and 19 severe dysplasia, according to blind duplicate assessments by two pathologists. Forty three were classified as tubular adenomas and 16 as "villous" adenomas (tubulo-villous and villous). The number ofmitoses, both per unit area of epithelium (area weighted mitotic counts, AWMC) and per colonic crypt (mitotic counts per colonic crypt MCCC), was scored in the most dysplastic area within the adenoma. Mitotic figures were counted using a light microscope (ocular x 10, objective x 40, NA 0 75), and the area of the glandular epithelium was measured using an interactive video overlay measurement system. Twenty glands per specimen were assessed. In the intra-observer reproducibility tests, the coefficients of error for the AWMC and MCCC were 4 5% and 7-4%/o respectively.Results-For the AWMC a significant difference was found between mild and moderate as well as between mild and severe dysplasia, but not between moderate and severe dysplasia. The results of the MCCC showed the same trend, but the differences did not reach a significant level. Furthermore, cases classified as mild dysplasia were found that showed numerous mitoses, while cases classified as severe dysplasia were found with only very few mitoses. No significant difference in AWMC was found between tubular and villous adenomas. Thus the different malignant potential of tubular and villous adenomas was not reflected by a difference in AWMC. A seemingly strong difference for MCCC between tubular and "villous" adenomas appeared to depend completely on the difference in crypt size between these two groups. Conclusions-The area weighted mitotic count, rather than the mitotic count per colonic crypt, may be useful for assessing the proliferation rate in colorectal adenomas. (J Clin Pathol 1995;48:620-625)

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Section: Resultsmentioning

confidence: 99%

Quantification of proliferative activity in colorectal adenomas by mitotic counts: relationship to degree of dysplasia and histological type.

Meijer

Baak

1995

Journal of Clinical Pathology

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“…In order to arrive at a more objectively defined risk assessment of a given lesion (Figure 4), several groups have performed image ana lysis to quantitatively assess colorectal glandular or epithelial characteristics [59][60][61][62][63][64][65]. Usually, cases of histologically normal mucosa and of low-, moderate-and high-grade dysplasia are examined using this technique, which has been improved by automated features and in more recent years use of knowledge-guided software.…”

Section: Morphometry and Quantitative Pathology Markersmentioning

confidence: 99%

Endoscopy, morphology, morphometry and molecular markers: predicting cancer risk in colorectal adenoma

Søreide¹,

Nedrebø

Reite

et al. 2009

Expert Review of Molecular Diagnostics

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The evaluation of short- and long-term risk for developing cancer in patients with colorectal adenomas is controversial. Good, reliable predictors of cancer risk in any adenoma are currently lacking and are limited to adenoma size, number and histologic type. In fact, the evaluation of any adenoma or precancer lesion (e.g., hyperplastic polyps, serrated adenoma or aberrant crypt foci) within the colorectum may be assessed by a number of techniques ranging from direct visualization through the endoscope, to microscopic assessment, and to evaluation at the molecular level. Emerging techniques may yield improved methods of adenoma risk-assessment in the near future. For one, newer endoscopy technologies include chromoendoscopy or endocytoscopy, which now render endoscopists able to resolve the surface and subsurface mucosa at cellular resolution in vivo and in real time - thus, bringing the microscope to the patient's bedside. This new era in endoscopic imaging is dubbed 'histoendoscopy'. Further, while traditional views of classifying protruding and sessile lesions include those of Haggitt, the sm-classification, the Japanese and the so-called Vienna classifications to evaluate neoplasia, the development of new molecular techniques may give way to new methods of classifying preneoplasia and precancerous lesions. This review discusses some pros and cons of risk evaluation technologies in the colorectal tract by endoscopy, microscopy, and quantitative and molecular features. The morphometry-based studies performed over the past decades for the quantitative assessment of cellular and nuclear features within adenomas have failed to yield results amenable for clinical translation and are unlikely to improve further and gain widespread use with current technology. Rather, emerging knowledge of pathway-specific markers through the outlining of a molecular classification will likely be the basis for improved detection and diagnosis. The emerging genomic and proteomic technologies allowing for noninvasive tests to detect (asymptomatic) cancer and neoplasia are discussed. Lastly, the importance of recognizing bias and pitfalls and the adherence to guidelines for biomarker research are addressed.

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“…The methods for applying stereology to colorectal adenomas have been extensively dealt with in a recent paper of ours. 13 A test grid was projected over the low-magnification image of the tissue (Fig. 3).…”

Section: Quantitative Analysesmentioning

confidence: 99%

“…9,10 Previously we have shown that a number of quantitative methods can objectively describe the nuclear and glandular changes in colorectal adenomas, as well as the mitotic activity. [11][12][13][14] In the present study, we set out to evaluate the additional prognostic value of these quantitative pathological features in rectosigmoid adenomas with respect to the risk of metachronous colorectal cancer.…”

Section: Introductionmentioning

confidence: 99%

Predicting the risk of metachronous colorectal cancer in patients with rectosigmoid adenomas using quantitative pathological features. A case-control study

Meijer¹,

Baak²,

Talbot³

et al. 1998

J. Pathol.

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This paper addresses the problem of the greenhouse crop growth control using a hierarchical control approach. The proposed control scheme consists of two layers. In the lower one, adaptive and predictive controllers are used. The system dynamics at this level are described with hybrid models that arise due to the different modes of operating/controlling the greenhouse climate (heating and ventilation). As a result, different choices for the state of the system can be considered where inner temperature, solar radiation, and optimized set‐points will act as logical conditions in the description of the hybrid system. The hybrid dynamics are described both in a general way and using a MLD representation, this result being useful for control purposes in the greenhouse climate control community. The upper layer calculates optimal climate set‐points based on economic criteria. An optimization algorithm is used with a receding horizon strategy to provide the desired climate to the lower layer during the whole campaign. Representative experimental results of the implementation of the hierarchical control architecture are presented and discussed in the paper. Copyright © 2007 John Wiley & Sons, Ltd.

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Stereological Assessment of Architectural Changes in Dysplastic Epithelium of Colorectal Adenomas

Cited by 10 publications

References 17 publications

Quantification of proliferative activity in colorectal adenomas by mitotic counts: relationship to degree of dysplasia and histological type.

Quantification of proliferative activity in colorectal adenomas by mitotic counts: relationship to degree of dysplasia and histological type.

Endoscopy, morphology, morphometry and molecular markers: predicting cancer risk in colorectal adenoma

Predicting the risk of metachronous colorectal cancer in patients with rectosigmoid adenomas using quantitative pathological features. A case-control study

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