Micromorphometry of colonic lesions.

In the formulation of a quantitative component for the knowledge base of a diagnostic expert system, we developed a mathematical model to describe nuclear placement patterns in colon. Glands from normal colon, tubular adenomas, and adenocarcinomas were studied, and a ratio developed of percentage internally displaced nuclei to percentage displacement area. This displacement area represented an inner epithelial zone bounded centrally by the lumen and peripherally by the apical limit of basal nuclei. The mean percentage internally displaced nuclei to percentage displacement area ratio was 0.15 +/- 0.13 for normal glands, 0.75 +/- 0.09 for adenomas, and 1.04 +/- 0.13 for carcinomas. When the percentage internally displaced nuclei to percentage displacement area ratio was plotted against total number of nuclei, there was statistically significant separation of the diagnostic categories at alpha less than or equal to 0.05. Relative nuclear area and its variance were also studied for normal colonic glands, adenomas, and adenocarcinomas. Mean relative nuclear area for cells from normal glands was 284.2, from adenomas 342.4, and from adenocarcinomas 416.4, these being statistically significantly different at alpha less than or equal to 0.05. Variance of relative nuclear area, compared for the three diagnostic categories, was statistically significantly increased only in adenocarcinoma. Quantitation of nuclear placement patterns appears to provide a useful diagnostic clue for the knowledge base of a diagnostic expert system in the discrimination among normal colonic glands, adenomas, and adenocarcinomas.