Use of morphometry as an aid in the differential diagnosis of large cell carcinoma of the lung.
In a previous cytopathologic study a regression equation was generated that aided in the differential diagnosis of large cell carcinoma (LCC) of the lung from poorly differentiated adenocarcinoma (AC). This study was undertaken to validate and extend those findings. Cytopathologic and histopathologic specimens from 20 new patients were examined using computerized morphometry. There were 28 specimens from 10 cases of LCC and 25 specimens from 10 cases of AC (10-25 cells measured from each specimen). Histopathologic review by an expert (S.D.G.) provided the "gold standard" diagnosis. Morphometric parameters studied were (1) nucleolar/nuclear area ratio, (2) cell area, (3) cell form factor, and (4) nuclear form factor. Sensitivity analysis validated the diagnostic utility of our prior equation. A logistic regression with these parameters determined the probability that each sample was LCC. Relative operating characteristic curve analysis determined an optimum logistic cutoff point of 0.83. At this decision level the equation had a sensitivity of 72% for distinguishing LCC. Specificity was 46%, positive predictive value was 65%, negative predictive value was 55%, and classification efficiency was 61%. Morphometry of histopathologic material contributed no important additional information. Therefore, our logistic regression and sensitivity analysis supported the clinical utility of certain morphometric measurements in the cytopathologic, but not histopathologic, diagnosis of LCC.
Department of Pathology, DX, Inc., Midland, Texas 79701.
T R
TR
Burns
T A
TA
Teasdale
S D
SD
Greenberg
D000230:Adenocarcinoma / Q000473:pathology; D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology* / Q000648:ultrastructure; D002466:Cell Nucleolus / Q000473:pathology; D002467:Cell Nucleus / Q000473:pathology; D048429:Cell Size; D003937:Diagnosis, Differential; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008175:Lung Neoplasms / Q000473:pathology* / Q000648:ultrastructure; D008297:Male; D008875:Middle Aged