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Article
Diagnostic Approach of Atypical Cells in Effusion Cytology Using Computerized Image Analysis

Author: Zainab A J Al-Obaidi
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2007 Volume: 4 Issue: 1 Pages: 60-62
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Cytology is one of the important diagnostic tests done on effusion fluid. It can detect malignant cells in up to 60% of malignant cases.
The most important benign cell present in these effusions is the mesothelial cell.
Mesothelial atypia can be striking andmay simulate metastatic carcinoma. Many clinical conditions may produce such a reactive atypical cells as in anemia,SLE, liver cirrhosis and many other conditions.
Recently many studies showed the value of computerized image analysis in differentiating atypical cells from malignant adenocarcinoma cells in effusion smears. Other studies support the reliability of the quantitative analysisand morphometric features and proved that they are objective prognostic indices.
Methods: Sixty three cases of pleural and peritoneal smears, previously reported as benign (19) cases, malignant (21) cases or atypical (23) cases, were retrieved from the files. In each of these smears; nuclear area, perimeter, and roundness coefficient of 80-100 cell were determined at x400 magnification by the use of image analysis system.
Statistical analysis was performed using analysis of variance and Tukey's HSD test.
Results: The mean values of nuclear roundness, nuclear perimeter and nuclear area vary between the three groups (benign, atypical and malignant cells) by using analysis of variance (p > 0.01).
The value of nuclear roundness, perimeter and area did not differ significantly between benign and atypical cells (Tukey’s test: p<0.01).
On the other hand, the value of nuclear roundness, perimeter and area showed a significant difference between malignant and atypical cells(Tukey's test: p> 0.01).
Conclusion: In conclusion, our data suggest that cytomorphometry performed on effusion smear cells may provide important information for the differentiation of atypical cells from malignant cells, in which the values of atypical cells are closer to those of benign cells during the examination of pleural and peritoneal smears by the use of image analysis system.
Key words: Effusion cytology, Atypical cells, Cytomorphometry


Article
Correlation between the conventional, routine histological grading of transitional cell carcinoma of the urinary bladder and morphometric analysis

Authors: Hassanain A.J Al-Obaidi --- Zainab A.J. Al-Obaidi
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2007 Volume: 49 Issue: 1 Pages: 107-110
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Transitional cell carcinoma of the urinary bladder is one of the important malignancies in both sex groups .It is considered as a heterogenous neoplasm with different biological behavior, in which the majority are early non invasive with tendency for recurrence and some may progress to invasive tumor. An important clinicopathological features are ,the tumor stage and histological grade which are used as prognostic parameters of the tumor and play an important role in therapy. Due to the subjectivity of the histological grading , the reproducibility was low . Many studies showed the value of quantitative analysis of the tumor as an important method in determining the recurrence of the tumor and muscular invasion, some other studies showed the value of nuclear measurement as a prognostic tool for bladder carcinoma. Aim of the study: To evaluate the benefit of nuclear image analysis as an objective method for grading of transitional cell carcinoma of the urinary bladder and compare it with the subjective routine histological grading. Material and method: Sixty two cases of transitional cell carcinoma of the urinary bladder, histologically diagnosed and graded according to WHO grading system ,were selected . In each case 8-10 HPF were examined &10-20consecutive cells were studied, also we measured the largest 10 nuclei for each case separately by a computerized image analysis system at x400 magnification. Nuclear area and roundness were determined. Statistical analysis was performed using the analysis of variance and Tukey’s test (HSD). Results: There was no statistical difference in the mean value of nuclear roundness between the three grades (P<0.05), while there was a statistical difference between grade I&III of their mean nuclear area (MNA) &MNA of the largest 10 nuclei (P<0.05). No such difference was found between grade I&II or grade II&III (P<0.05). Conclusion: Morphometric analysis should be based on the selection of special areas and not by random measurement as done on routine histological grading.


Article
Cytological Grading of Fine Needle Aspirates from Breast Carcinoma
التقييم الخلوي لدرجة خبث سرطان الثدي بواسطة الرشف بالأبره الدقيقه

Authors: Zainab A.J. AL-Obaidi د.زينب عبد الجبار العبيدي --- Raji H. AL-hadithi د.راجي حسين الحديثي
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2006 Volume: 19 Issue: 3 Pages: 239-243
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Abstract:Background: Breast carcinoma is the most common malignant tumor in females at the age group (15-74) years. Because neoadjuvant therapy including preoperative chemotherapy and tamoxifen is becoming increasingly common for treating early breast carcinoma, itُ s desirable to grade the tumor before surgery to select the appropriate treatmentAim of the study: 1-Grading the cytological material obtained by FNA performed on malignant breast lesions. 2-Assess the reliability of FNA by comparison with histopathology.Material & Method: One hundred and three malignant cases of breast lesions diagnosed by FNA were reviewed in Al-Kadhmiah Teaching Hospital from 1994-1998. Their histopathological confirmation was present in 91 cases only. Those aspirates were stained by H&E stain & were graded according to the Robinson grading system using six cytological parameters; cell dissociation, cell size, cell uniformity, nucleoli, nuclear margin & chromatin pattern and then grade them into three grades according to the total scores.Results: We were able to correctly correlate 74 cases (81.3%) of FNA cytological material graded according to the mentioned criteria with their histological grading for ductal carcinoma. For lobular carcinoma only histopathological confirmation was done. Performing Chi-square testX²=67.4 (p≤0.001).Conclusions: Cytological grade does not correspond exactly to histological grade but it is equally good if the variability in histological grade is considered due to tumor heterogeneity. Also the value of Robinson´s grading system in cytological grading since it is simple, take little time & the information obtained is of clinical use & may be of prognostic value especially when combined with mammographic findings. Key words: Breast carcinoma, FNA, grading.

الملخص:يعتبر سرطان الثدي من الأورام الشائعه في الإناث للعمر15-74 سنه . وحيث أن العلاج المواد الكيمياويه والتاموكسفين قبل إجراء التداخل الجراحي لأورام الثدي أصبح ظاهره معروفه لعلاج حالات سرطان الثدي في مراحله الأولى فقد أصبح من المفضل تقييم درجة خبث السرطان عن طريق الفحص الخلوي وذلك قبل أجراء أي تداخل جراحي ليتم أختيار أفضل نظام علاجي.الهدف من البحث : 1-معرفة درجة خبث الخلايا السرطانيه لسرطان الثدي بالفحص الخلوي (الرشف بالأبره الدقيقه ). 2-تقييم الفحص الخلوي وذلك بمقارنة نتائجه ومدى مطابقتها للفحص النسيجي لنفس الورم.المواد وطريقة العمل :تم مراجعة 103 حاله لسرطان الثدي تم تشخيصها عن طريق الفحص الخلوي بواسطة الرشف بالأبره الدقيقه في مستشفى الكاظميه التعليمي للفتره من 1994-1998 . صبغت هذه الحالات بصبغة الهيماتوكسلين والأيوسين وتم تقييم درجة خبث الخلايا السرطانيه فيها بواسطة نظام روبنسون لتقييم درجة الخبث معتمدًا على 6 صفات خلويه وهي : 1-التنافر بين الخلايا .2-حجم الخليه. 3-مدى التشابه بين الخلايا. 4-ظهور النويه. 5-حافات النواة. 6-مادة الكروماتين. وصنفت درجة الخبث الى ثلاثة درجات معتمدين الصفات المذكور وقورنت في 91 حاله مع مقاطعها النسيجيه. النتائج : أظهرت النتائج تطابق الفحصين الخلوي والنسيجي في 74 حاله (3و81%) من حيث تقييم درجة خبث الورم السرطاني معتمدين فيها على نظام روبنسون للفحوص الخلويه ونظام ريتشاردسون وبلوم المبدل لتقييم درجة خبث الأورام السرطانيه القنويه والتطابق النسيجي فقط (دون تقييم درجة الخبث ) للاورام السرطانيه الفصيصيه .وأختلفت نتائج الفحصين الخلوي والنسيجي في 17 حاله ( 6و18%) .وتبين من الفحص الأحصائي أن قيمة P ≤ 001و0 الذي يدل على أن تقييم درجة الخبث بواسطة الفحص الخلوي لاينطبق 100% مع التقييم النسيجي لكنه يفي بالغرض اذا ما اخذ بنظر الاعتبارأختلاف الوضع الخلوي للورم السرطاني . الاستنتاج : ان نظام روبنسون لتقييم درجة خبث أورام الثدي السرطانيه بواسطة الرشف بالأبره الدقيقه يعتبر نظام سهل التطبيق وسريع، والمعلومات المستمده منه معتمده في التشخيص السريري وقد تكون ذات أهميه في معرفة تطور الورم خصوصا اذا ما أستعمل مع تصوير الثدي الشعاعي لأعطاء نتائج أكثر دقه.

Keywords

Breast carcinoma --- FNA --- grading.

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