Diagnostic value of computerized nuclear morphometry for the prediction of malignancy in liver fine needle aspiration cytology.
OBJECTIVE
To evaluate the diagnostic value of nuclear parameters using computerized morphometry in the differential diagnosis of well-differentiated hepatocellular carcinoma (WD-HCC) and regenerative atypia in liver fine needle aspiration cytology (FNAC).


METHODS
All 78 cases, including 30 negative, 30 positive and 18 suspicious liver FNA cytology smears were examined with regard to nuclear area, nuclear perimeter, largest to smallest diameter ratio of the nuclei (L/S ratio) and coefficient of variation of the nuclear area (NACV). The diagnostic value was assessed using receiver operating characteristics (ROC) curves. Cutoff points were determined by the area under the ROC curve (AUC), which provides the highest combined sensitivity and specificity.


RESULTS
The nuclear area and perimeter in liver FNA were more helpful than L/S ratio and NACV in discriminating between hepatocytes with regenerative atypia and WD-HCC. Cutoff points of 56.67 for nuclear area and 27.16 for perimeter were suggested to help shift the suspicious diagnoses to WD-HCC.


CONCLUSIONS
When faced with difficult diagnoses on liver FNA, we suggest application of computerized morphometry may be a helpful ancillary diagnostic tool in the further classification of such cases.
Wen
Chien-Hui
CH
Department of Pathology, Division of Chest Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Huang
Ming-Shyan
MS
Wang
Sheng-Lan
SL
Su
Yue-Chiu
YC
Yang
Sheau-Fang
SF
Chai
Chee-Yin
CY
D044963:Biopsy, Fine-Needle; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000473:pathology; D002467:Cell Nucleus / Q000473:pathology; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D003937:Diagnosis, Differential; D022781:Hepatocytes / Q000473:pathology; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology; D012680:Sensitivity and Specificity