Evaluating IPMN and pancreatic carcinoma utilizing quantitative histopathology.
Intraductal papillary mucinous neoplasms (IPMN) are pancreatic lesions with uncertain biologic behavior. This study sought objective, accurate prediction tools, through the use of quantitative histopathological signatures of nuclear images, for classifying lesions as chronic pancreatitis (CP), IPMN, or pancreatic carcinoma (PC). Forty-four pancreatic resection patients were retrospectively identified for this study (12 CP; 16 IPMN; 16 PC). Regularized multinomial regression quantitatively classified each specimen as CP, IPMN, or PC in an automated, blinded fashion. Classification certainty was determined by subtracting the smallest classification probability from the largest probability (of the three groups). The certainty function varied from 1.0 (perfectly classified) to 0.0 (random). From each lesion, 180 ± 22 nuclei were imaged. Overall classification accuracy was 89.6% with six unique nuclear features. No CP cases were misclassified, 1/16 IPMN cases were misclassified, and 4/16 PC cases were misclassified. Certainty function was 0.75 ± 0.16 for correctly classified lesions and 0.47 ± 0.10 for incorrectly classified lesions (P = 0.0005). Uncertainty was identified in four of the five misclassified lesions. Quantitative histopathology provides a robust, novel method to distinguish among CP, IPMN, and PC with a quantitative measure of uncertainty. This may be useful when there is uncertainty in diagnosis.
University of Tennessee Health Sciences Center, Memphis, Tennessee.
Evan S
ES
Glazer
The University of Arizona, Tucson, Arizona.
Hao Helen
HH
Zhang
University of Colorado, Denver, Colorado.
Kimberly A
KA
Hill
The University of Arizona, Tucson, Arizona.
Charmi
C
Patel
The University of Arizona, Tucson, Arizona.
Stephanie T
ST
Kha
The University of Arizona, Tucson, Arizona.
Michael L
ML
Yozwiak
The University of Arizona, Tucson, Arizona.
Hubert
H
Bartels
The University of Arizona, Tucson, Arizona.
Nellie N
NN
Nafissi
The University of Arizona, Tucson, Arizona.
Joseph C
JC
Watkins
The University of Arizona, Tucson, Arizona.
David S
DS
Alberts
CMC Veterans Affairs Medical Center, Philadelphia, Pennsylvania. robert.krouse@va.gov.|University of Pennsylvania, Philadelphia, Pennsylvania. robert.krouse@va.gov.
Robert S
RS
Krouse
D002288:Adenocarcinoma, Mucinous / Q000145:classification / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000145:classification / Q000473:pathology*; D002291:Carcinoma, Papillary / Q000145:classification / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000145:classification / Q000473:pathology*
Intraductal papillary mucinous neoplasms; karyometry; nuclear chromatin pattern; pancreatic carcinoma; quantitative histopathology
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