Using Digital Pathology to Understand Epithelial Characteristics of Benign Breast Disease among Women Undergoing Diagnostic Image-Guided Breast Biopsy.
Using Digital Pathology to Understand Epithelial Characteristics of Benign Breast Disease among Women Undergoing Diagnostic Image-Guided Breast Biopsy.
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使用数字病理学了解接受图像引导乳腺活检的女性良性乳腺疾病的上皮特征。
DOI：
10.1158/1940-6207.capr-19-0120
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发表时间：
2019
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作者：
Mullooly,Maeve;Puvanesarajah,Samantha;Fan,Shaoqi;Pfeiffer,RuthM;Olsson,LinneaT;Hada,Manila;Kirk,ErinL;Vacek,PamelaM;Weaver,DonaldL;Shepherd,John;Mahmoudzadeh,Amir;Wang,Jeff;Malkov,Serghei;Johnson,JasonM;Hewitt,StephenM;
延迟性终末导管小叶单位（TDLU）退化与乳腺X线摄影乳腺密度（MD）升高相关。两者都是良性乳腺疾病（BBD）女性中独立的乳腺癌风险因素。之前对正常乳腺组织的数字分析显示，上皮细胞核密度（END）和TDLU退化呈负相关。因此，我们研究了BBD临床活检中END、TDLU退化和MD的相关性。本研究纳入了224名诊断为BBD的女性的262份代表性图像引导苏木精和伊红染色活检的数字化图像，这些女性入组了横断面BREAST-Stamp项目，并对TDLU退化进行了目视评估（TDLU计数/100 mm 2，中位数TDLU跨度和中位数腺泡计数/TDLU）。数字算法估计每单位上皮面积的细胞核计数，或END。活检前同侧头尾位数字化乳腺X线片的单次X线吸收测量法测量活检区域周围的全局和局部MD。调整有序逻辑回归模型评估TDLU和END指标三分位数之间的关系。协方差分析检查了END三分位数之间MD的平均差异。TDLU测量值与增加的END三分位数呈正相关[TDLU计数/100 mm 2，ORT 3与T1：3.42，95%置信区间（CI），1.87-6.28;腺泡计数/TDLUT 3与T1：2.40，95% CI，1.39-4.15]。END与局部MD显著相关，但与整体MD无关。在非增殖性BBD患者中相关性最明显。这些结果表明，定量END反映了视觉TDLU和放射学MD测量捕获的组织学信息的不同但互补的信息，并且在评估乳腺实质的细胞构成以了解BBD的病因方面值得继续评价。
Delayed terminal duct lobular unit (TDLU) involution is associated with elevated mammographic breast density (MD). Both are independent breast cancer risk factors among women with benign breast disease (BBD). Prior digital analyses of normal breast tissues revealed that epithelial nuclear density (END) and TDLU involution are inversely correlated. Accordingly, we examined associations of END, TDLU involution, and MD in BBD clinical biopsies. This study included digitized images of 262 representative image-guided hematoxylin and eosin–stained biopsies from 224 women diagnosed with BBD, enrolled within the cross-sectional BREAST-Stamp project that were visually assessed for TDLU involution (TDLU count/100 mm2, median TDLU span and median acini count per TDLU). A digital algorithm estimated nuclei count per unit epithelial area, or END. Single X-ray absorptiometry of prebiopsy ipsilateral craniocaudal digital mammograms measured global and localized MD surrounding the biopsy region. Adjusted ordinal logistic regression models assessed relationships between tertiles of TDLU and END measures. Analysis of covariance examined mean differences in MD across END tertiles. TDLU measures were positively associated with increasing END tertiles [TDLU count/100 mm2, ORT3vsT1: 3.42, 95% confidence interval (CI), 1.87–6.28; acini count/TDLUT3vsT1, OR: 2.40, 95% CI, 1.39–4.15]. END was significantly associated with localized, but not, global MD. Relationships were most apparent among patients with nonproliferative BBD. These findings suggest that quantitative END reflects different but complementary information to the histologic information captured by visual TDLU and radiologic MD measures and merits continued evaluation in assessing cellularity of breast parenchyma to understand the etiology of BBD.