Department of Pathology, Turku, Finland
Medica – Odontologica 2003
The aim of this study was to improve the evaluation of E-cadherin immunostaining for distinguishing the aggressive variants of breast cancer, and to study the potential of DNA cytometry and nuclear morphometry in supporting the interpretation of fine needle aspiration biopsy (FNAB) of breast disease. Both histological (157 samples) and cytological material (151 samples) were used. We tested the E-cadherin immunostaining in paraffin sections (I). The method graded the intensity of the membrane staining (grades 0,1,2,3) and the area of fraction of cancer tissue which was stained at respective staining grade. At the cut-point 0.35 the index divided all 157 patients (P=0.0188), and node-positive patients (P=0.0006) in two groups of different survival. In this thesis, we also studied the DNA image cytometry, and nuclear morphometry of FNAB of different breast lesions. In DNA image cytometry, we found that the DNA cytometry has a potential to support differential diagnosis of breast lesions. And when applying selective sampling strategies one can improve the performance of the DNA cytometry in detecting DNA abnormalities (II, IV). We also studied the value of nuclear morphometry in FNAB diagnosis. The study showed that morphometry has diagnostic significance in FNAB especially when measurement is done from free cells and cell groups, and that the morphometry based results are associated with the type of histogram abnormalities (III). Morphometry and DNA cytometry of apocrine change was studied (IV). We found that the combined morphometric and DNA cytometric analysis may help in distinguishing between apocrine change and carcinoma. The present study may help in creating decision support method mainly based on E-cadherin immunostaining, DNA cytometry, and morphometry. This method could be potentially used to predict the outcome of breast cancer patients and for cytological diagnosis.
Keywords: e-cadherin immunostaining, dna cytometry, morphometry, fnab, breast lesions