[Development of a bank of morphometric data on breast diseases using the Integral-2MT analyzer].
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Biomedical subjects
Publications and source records attributed to A S Petrova.
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Based on a correlation of the results of cytological and histological assays in 1213 patients, the authors have analysed the correct and erroneous verifications of the cancer pattern according to cytological preparations. Under consideration are the possibilities and limitations of the cytological verification of different histological patterns and degree of differentiation of cancer of the lung, stomach, breast and thyroid. Standard cytological conclusions in accordance with the suggested cytological classifications of cancer of these organs are discussed.
Cytologic assay of metastatic involvement of lymph nodes may be used along with histological studies as a reliable adjunct for morphological diagnosis, that makes possible in many cases to determine not only the epithelial origin of the affection but also to characterize its histological pattern. However, the cytologic diagnosis of undifferentiated cancer metastases is frequently rather difficult in relation to establishing the differential diagnosis between the former and other affections of lymph nodes. A careful, and sometimes repeated analysis of the material, taking into account the clinical data and cytochemical findings, contributes to greater efficiency of a cytologic method. The perspective use of cytochemical reactions as additional criteria for the diagnosis of undifferentiated cancer necessitates their further elaboration and study.
The rationale of using clinical cytodiagnostics for preoperative recognition of salivary gland neoplasms is shown. As a result of using diagnostic puncturing in 44 examined patients the character of the pathological process was precisely determined in 88.6%, and the tumor was typed histologically in 66.7%.
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The content of DNA was investigated by the method of pulsed cytophotometry in cells of the following neoplasms: pulmonary cancer, benign lesions and cancer of the stomach, melanomas of the skin, malignant lymphomas and metastases of cancer into the lymphatic node. In the normal tissues and benign tumours the number of proliferating cells (DNA value of 3p, 4p) was not significant--from 2.0 to 5.0%. Polyploid cells were absent. In tumours the number of cells varied broadly--proliferating cells from 5.0 to 27,0%, polyploid cells from 9.0 to 40.0%. The use of the method of pulsed cytophotometry in prophylactic examinations is not effective, since in many cases changes could be detected only in single cells not identifiable on DNA-cytograms. Investigation of DNA content by the method of pulsed cytophotometry in a great number of tumour cells makes it possible to determine more accurately the character of the tumoral process, the level of differentiation of the tumoral tissue.
To date, the experience obtained evidence that the modern level of cytological diagnostics allows its being referred to as a separate branch of clinical medicine, that can provide morphological diagnosis of malignancies and other pathological processes. Cytological assay, as shown by reports of leading oncological institutes, should be employed in any therapeutic establishment already during patients' primary address to a specialist. A special importance is attached to cytological assay in mass prophylactic examinations as an effective adjunct for prophylaxis and early recognition of cancer of the cervix, stomach, lung, skin. The principles of the organization of special service of clinical cytology in the USSR are substantiated.
The results of the karyometric measurements in different thyroid diseases (both benign proliferative processes and cancer) have shown that this method may be useful in differential diagnosis of these diseases. It was also found that there are evident differences between the shapes of histograms in various forms of cancer. The shape of the histogram depends not only on the histological structure of the tumour (follicular, papillary, undifferentiated cancer), but also on the type of the cells of which it consists (A,B or C cells).
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It is shown that in the course of a cytological investigation it was possible not only to diagnose lymphogranulomatosis but in the overwhelming majority of cases to determine a morphological variant of the disease in accordance with Lukes et al. classification. Cytological pictures of the three histological variants of lymphogranulomatosis are described: mixed-cellular, reticular and nodular sclerosis. Cytological criteria for diagnosis of nodular sclerosis are identified.
Parallel cytological and histological investigations in 511 patients with of the lung cancer confirmed the possibility of verification of a tumour form on the basis of cytological preparations. Determination of cancer forms is carried out on the basis of the same principle criteria which are used in a histological investigation. The first stage of diagnosis consists in search for cellular, structural and functional signs of epidermoid and glandular differentiation. In the absence of these, there are grounds to consider the diagnosis to be non-differentiated cancer with subdivisions into micro- and macrocellular variants. Squamous-cell carcinoma with cornification highly differentiated adenocarcinoma and non-differentiated microcellular cancer possess characteristic features ensuring a highly reliable-cytological diagnosis. Cytological diagnosis of squamous-cell cancer was correct in 95.3% of cases, that of non-differentiated microcellular cancer-in 87.1%, and that of glandular cancer-in 81.2% of cases. The majority of errors made in verification of squamous-cell and glandular cancer were made with respect to their poorly differentiated forms which have no reliable cytological characteristics. The last statement is also true with respect to non-differentiated macrocellular cancer of the lung.