摘要目的 探讨计算机图像分析的腺腔圆度测量在胃高分化腺癌病理组织学中的诊断参考价值.方法 收集2016年1月至7月经病理组织学诊断为胃高分化腺癌的10份H-E染色切片,另纳入同期经病理诊断为胃黏膜增生和正常胃黏膜各6份H-E染色切片作为对照,均扫描成数字切片,并对其腺腔圆度值、长径值和短径值进行测量比较.统计学方法采用Kruskal-Wallis秩和检验.结果 正常胃黏膜组、胃黏膜增生组和胃高分化腺癌组的腺腔圆度值分别为79.7°(10.6°)、73.0°(12.3°)和58.6°(15.2°),3组间差异有统计学意义(H=494.827,P＜0.01);正常胃黏膜组的腺腔圆度值大于胃黏膜增生组和胃高分化腺癌组,差异均有统计学意义(T=156.007、-508.579,P均＜0.01);胃黏膜增生组的腺腔圆度值大于胃高分化腺癌组,差异有统计学意义(T=-352.572,P＜0.01).正常胃黏膜组、胃黏膜增生组和胃高分化腺癌组的腺腔长径值分别为24.1 μm(11.8 μm)、43.1 μm(28.8 μm)和96.0 μm(79.3 μm),3组间差异有统计学意义(H=744.987,P＜0.01).正常胃黏膜组、胃黏膜增生组和胃高分化腺癌组的腺腔短径值分别为16.0 μm(8.7 μm)、22.7 μm(13.1 μm)和33.5 μm(38.0,μm),3组间差异有统计学意义(H=248.170,P＜0.01).结论 胃腺腔圆度值可作为正常胃黏膜、胃黏膜增生和胃高分化腺癌鉴别诊断的有效指标.

abstractsObjective To investigate the diagnostic value of computer image analysis assisted aroundness measurement of gastric gland lumens in well-differentiated gastric adenocarcinoma.Methods From January 2016 to July 2016,10 hematoxylin-eosin (H-E) stained slides of pathologically diagnosed well-differentiated gastric adenocarcinoma were collected.At the same period,H-E stained slides of gastric epithelial hyperplasia and normal gastric mucosa,six slides of each,were collected as controls.All of them were scanned into high resolution.Digital data roundness,long diameter and short diameter were measured and compared.Kruskal-Wallis rank sum test was used for statistical analysis.Results The median values of lumen roundness of normal gastric mucosa,gastric epithelial hyperplasia and welldifferentiated gastric adenocarcinoma were 79.7°(10.6°),73.0°(12.3°) and 58.6°(15.2°),respectively,and the difference among three groups was statistically significant (H=494.827,P＜0.01).The values of gland roundness of normal gastric mucosa were higher than those of gastric mucosal hyperplasia and welldifferentiated gastric adenocarcinoma,and the differences were statistically significant (T=156.007 and -508.579,both P＜0.01).The value of gland roundness of gastric mucosal hyperplasia was higher than that of well-differentiated gastric adenocarcinoma,and the difference was statistically significant (T=-352.572,P＜0.01).The values of long diameter of gland lumens in normal gastric mucosa,gastric mucosal hyperplasia and well-differentiated gastric adenocarcinoma were 24.1 μm(11.8 μm),43.1 μm (28.8 μm),and 96.0 μm(79.3 μm),respectively,and the difference among three groups was statistically significant (H=744.987,P＜0.01).The values of short diameter of gland lumens in normal gastric mucosa,gastric mucosal hyperplasia and well-differentiated gastric adenocarcinoma were 16.0 μm (8.7 μm),22.7 μm (13.1 μm) and 33.5 μm (38.0 μm),respectively,and the difference among three groups was statistically significant(H=248.170,P＜0.01).Conclusion The roundness of gastric gland lumens can be used as an effective parameter for the differential diagnosis of normal gastric mucosa,gastric mucosal hyperplasia and well-differentiated gastric adenocarcinoma.