Potential role of nuclear appearance in pathologic recognition and delimitation of sessile serrated polyps of the colon: a karyometric study.
OBJECTIVE
To estimate the extent to which surgical pathologists can rely on abnormal nuclear appearance to recognize sessile serrated adenoma (SSP) and to define its extent.


METHODS
Digitized images of nuclei of superficial crypt cells from SSPs, banal hyperplastic polyps (BHPs), tubular adenomas (TAs) and normal colonic mucosa (N) in surgical pathology specimens were analyzed for size, shape, area, optical density (summed and average) and 22 Markovian texture characteristics.


RESULTS
Statistical classification functions correctly distinguished TA from N nuclear image profiles in 93.3% of cases, SSP from N in 70.0% and BHP from N in 74.1%. SSP nuclear feature vectors were less effectively separated from N than BHP and TA on discriminant analysis of the combined data set, and correct classification was achieved in 79.6% of TAs, 53.5% of SSPs and N and 64.2% of BHPs.


CONCLUSIONS
Karyometry distinguished stained nuclei of TAs, but had limited ability to separate nuclei of SSP from those of N and BHP. This suggests that the pathologist attempting to diagnose or delimit the margins of an SSP will find nuclear appearances less helpful than when examining a TA.
Smith
Fred B
FB
Department of Pathology, Saint Vincent's Catholic Medical Centers of New York-Manhattan, 170 West 12th Street, New York, New York 10011, USA. fredbsmith@pol.net
Aksenov
Sergei
S
D000230:Adenocarcinoma / Q000648:ultrastructure; D002467:Cell Nucleus / Q000648:ultrastructure*; D003110:Colonic Neoplasms / Q000648:ultrastructure; D003111:Colonic Polyps / Q000648:ultrastructure*; D006801:Humans; D007620:Karyometry / Q000379:methods*