Endometrial cancer (EC) in women is increasing globally, necessitating improved diagnostic methods and prognosis prediction. While endometrial histology is the conventional approach, liquid-based endometrial cytology may benefit from novel analytical techniques for cell clusters. A clinical study was conducted at the University of Fukui Hospital from 2012 to 2018, involving 210 patients with endometrial cytology. The liquid-based cytology images were analyzed using cell cluster analysis with Image J software. Logistic regression, ROC analysis, and survival analysis were employed to assess the diagnostic accuracy and prognosis between cell cluster analysis and EC/atypical endometrial hyperplasia (AEH). Circularity and fractal dimension demonstrated significant associations with EC and AEH, regardless of age and cytology results. The ROC analysis revealed improved diagnostic accuracy when combining fractal dimension with cytology, particularly in menopausal age groups. Lower circularity and solidity were independently associated with poor overall survival, while higher fractal dimension values correlated with poorer overall survival in Grades 2 and 3 endometrial cancers. The combination of circularity and fractal dimension with cytology improved diagnostic accuracy for both EC and AEH. Moreover, circularity, solidity, and fractal dimension may serve as prognostic indicators for endometrial cancer, contributing to the development of more refined screening and diagnostic strategies.
全球范围内女性子宫内膜癌发病率持续上升，亟需改进诊断方法与预后预测手段。尽管子宫内膜组织学检查是传统诊断方式，但液基子宫内膜细胞学结合创新的细胞团簇分析技术可能更具优势。福井大学医院于2012年至2018年开展了一项临床研究，纳入210例接受子宫内膜细胞学检查的患者。研究采用Image J软件对液基细胞学图像进行细胞团簇分析，通过逻辑回归、ROC分析和生存分析评估细胞团簇分析对子宫内膜癌/非典型子宫内膜增生的诊断效能及预后价值。研究显示，无论年龄与细胞学结果如何，细胞团簇的圆形度和分形维数均与子宫内膜癌及非典型子宫内膜增生显著相关。ROC分析表明，分形维数与细胞学联合可提升诊断准确率，尤其在绝经年龄组更为显著。较低的圆形度与紧实度与不良总生存期独立相关，而在2-3级子宫内膜癌中，较高的分形维数值与较差的总生存期相关。圆形度与分形维数结合细胞学检查可同步提升对子宫内膜癌和非典型子宫内膜增生的诊断准确性。此外，圆形度、紧实度和分形维数有望成为子宫内膜癌的预后指标，为制定更精准的筛查与诊断策略提供依据。
肿瘤(癌症)患者之家