| Objective:Using the method of stereology to reveal quantitatively and systematically the characteristics and changing rules of the three-dimensional structure of the stomach epithelium neoplasm. To explore the value of the stereological parameters of the stomach epithelium neoplasm on the diagnosing, Set up the foundation for quantitative diagnose and prognosis judgment and analysis of the diseases.Methods:A total of 82 cases of stomach epithelium neoplasm specimens and normal stomach from the stomach surgical resections were collected. They consisted of 55 stomach carcinoma,8 stomach adenoma and 19 normal stomach specimens. The stomach carcinoma group consisted of 15 well-differentiated,20 moderately-differentiated and 20 poorly-differentiated.Ten fields were selected stochastically from each sections which was cut from three paraffin masses selected randomly and stained by HE.The volume density(Vvn.,epi),surface density(Svn,epi),ratio of surface to volume(Rsvn),mean free distance(λepi),mean volume(vn epi),numerical denstity(Nvn,epi),ratio of nuclear to plasm(Rnp),the numerical density on linear structure(NLS) for the stomach epithelium, were measured by ImagePro image analysis software system. The contacting space for Vvn,epi,Svn,epi,Nvn,epi,Rsvn,λepi,Vn.,epi,Sn.,epi,Rnp is epithelial cell,out space of the glands was used as reference space of Nls. The value of the parameters were compared to analyze the differences among the different groups. The following groups were separately submitted to do the discriminate analysis and stepwise discriminate analysis. They were the stomach carcinoma group, the stomach adenoma group and the normal stomach group; the differentiation of the stomach carcinoma group an the normal group; the stomach adenoma group and the normal group.Results:1. The measuring results of stereological parameters on the three dimensional of the stomach epithelium neoplasm:The eight parameters of Vvn,epi,Svn,epi,Nvn,epi,Rsvn,λepi,Vn.,epi,Sn.,epi,Rnp and NLs showed significant difference between the stomach carcinoma, the stomach adenoma and the normal stomach. The interclass compare test showed the Vvn,epi,Svn,epi,Vn,epi,Sn,epi and Rnp of stomach carcinoma were bigger than that of stomach adenoma and normal stomach separately;λepi of the stomach carcinoma were smaller than that of stomach adenoma and normal stomach, NLS of the stomach adenoma was bigger than that of the stomach adenoma and normal stomach. The Rsvn,λepi and Nvn,epi of the stomach adenoma were bigger than that of normal stomach. The Rsvn andλepi of the stomach adenoma was smaller than that of normal stomach. The difference of Svn,epi. Vn.,epi,Sn,epi,Nvn,epi between stomach adenoma and normal stomach were not significant, The difference of Svn,epi,Rsvn,Nvp,epi andλepi between stomach carcinoma and stomach adenoma were not significant.At different graded of differentiation in gastric adenocarcinoma, The Vvn.,epi,Svn,epi and Rnp of the poorly-differentiated were biggest, and the moderately-differentiated and the well-differentiated were decreased in order. Theλepi of well-differentiated were decreased in order. The Nvn,epi and Rsvn of the poorly-differentiated was biggest, the well-differentiated and the moderately-differentiated were decreased in order. The Vn.,epi of the moderately-differentiate was biggest, well-differentiated and the poorly-differentiated were decreased in order. The Sn,epi of the moderately-differentiate was biggest, the poorly-differentiated and well-differentiated were decreased in order.The cofficicents of variability(CV) of Vvn,epi,Svn,epi,Nvn,epi,Rsvn,λepi,Vn,epi,Sn,epi,Rnp and NLS in well-differentiated stomach adenocarcinoma were respectively 0.1293,0.2278,0.5824,0.1367,0.2004,0.3366,0.2379,0.1876 and 0.1322; The CV of the above parameters of moderately-differentiated stomach adenocarcinoma were respectively 0.1641,0.1794,0.4177,0.1396,0.2558,0.3596,0.2379,0.2535 and 0.2086; The CV of the above parameters of poorly-differentiated stomach carcinoma were respectively 0.1434,0.2098,0.2582,0.2835,0.2780,0.3075,0.3370and 0.3116; he CV of the above parameters of stomach adenoma were respectively 0.1221,0.1340,0.1460,0.0753,0.1686,0.0652,0.0613,0.1668 and 0.1604.2. The results of discriminant analysis and stepwise discriminant analysis on the stereological parameters of the stomach epithelium neoplasm1).The results of discriminant analysis:The discriminative function (1),(2),(3),(4),(5),(6) was set up cased on the parameters of Vvn,epi,Svn,epi,Nvn,epi,Rsvn,λepi,Vn,epi,Sn,epi,Rnp and NLS.To discriminate the stomach carcinoma,stomach adenoma and the normal stomach group using the discriminate function (1),the discriminative veracity were respectively 97.1%,87.5% and 100%;To discriminate the stomach carcinoma and the normal stomach group using function (2),the discriminative veracity were 97.1% and 100%; To discriminate the stomach adenoma and the normal stomach group using function (3),the discriminative veracity were 100%; To discriminate the stomach carcinoma and the stomach adenoma group using function (4),the discriminative veracity were 100% and 87.5% To discriminate well-differentiated, moderately-differentiated, the poorly-differentiated stomach adenocarcinoma and the normal stomach group using function (5), the discriminative veracity were respectively 46.7%,75%,95% and 84.2%; To discriminate well-differentiated, moderately-differentiated and the poorly-differentiated stomach adenocarcinoma group using function (6), the discriminative veracity were respectively 60%,65%,95%.The functions of (1),(2),(3),(4),(5) and (6) as follow:function (1)The Ya,Yb,Yc respectively represent the stomach carcinoma,stomach adenoma and normal stomachfunction (2)The Ya,Yc represent the stomach carcinoma and normal stomachfunction (3)The Yb,Yc represent the stomach adenoma and normal stomachfunction (4) The Ya,Yb represent the stomach carcinoma and stomach adenomafunction (5)The Ya1,Ya2,Ya3,Yc respectively represent well-differentiated,moderately-differentiated poorly-differentiated stomach carcinoma and normal stomachfunction (6)The Ya1,Ya2,Ya3,Yc respectively represent well-differentiated,moderately-differentiated poorly-differentiated stomach carcinoma2) The results of stepwise discriminant analysis:the discriminative function (7) was set up based on the four parameters of Svn,epi,Vvn,epi,Sn,epi and NLs,and the discriminative veracity to discriminant the stomach carcinoma,the stomach adenoma and normal stomach group were separately 97.1%,87.5% and 100%. The discriminative function (8) was set up based on the three parameters of Sn,epi,Nvn,epi 和and NLs.and the discriminative veracity to discriminant the stomach carcinoma and normal stomach group were separately 97.1% and 100%. The discriminative function (9) was set up based on the two parameters of Rsvn and NLS and the discriminative veracity to discriminant the stomach adenoma and normal stomach group were 100%. The discriminative function (10) was set up based on the four parameters ofλepi,Vn,epi,Sn,epi and NLS the discriminative veracity to discriminant the stomach carcinoma and the stomach adenoma group were 100% and 87.5%. The discriminative function (11) was set up based on the three parameters of Vvn,epi,Svn,epi,Rnp,λepi and Vn,epi and the discriminative veracity to discriminant the well-differentiated, the moderately-differentiated, the poorly-differentiated stomach adenocarcinoma and the normal stomach group were separately 53.3%,70%,95% and 84.2%. The discriminative function (12) was set up based on the two parameters of Vvn.epi and Svn.epi.and the discriminative veracity to discriminant the well-differentiated, the moderately-differentiated and the poorly-differentiated stomach adenocarcinoma were separately46.7%,75%和95%The functions of (7),(8),(9),(10),(11) and (12) as follow:function (7) the Ya,Yb,Yc respectively represent the stomach carcinoma,stomach adenoma and normal stomachfunction (8)The Ya,Yc represent the stomach carcinoma and normal stomach function(9)The Yb,Yc respectively represent stomach adenoma and normal stomachfunction (10)the Ya,Yb represent the stomach carcinomaand stomach adenomafunction (11)The Ya1,Ya2,Ya3,Yc respectively represent well-differentiated moderately-differentiated poorly-differentiated stomach carcinoma and normal stomachfunction (12)The Ya1,Ya2,Ya3 respectively represent well-differentiated,moderately-differentiated and poorly-differentiated stomach carcinomaConclusion:1.The diversity of Vvn,epi,Svn,epi,Nvn,epi,Rsvn,λepi,Vn,epi,Rnp and Nls between stomach carcinoma,stomach adenoma and normal stomach is obvious and has come regular, and the quantitative analysis of these parameters is useful to study the auxiliary diagnosis and classification of stomach epithelium neoplasm.2. The parameters of Vvn,epi,Svn,epi,Rsvn,λepi,vn.,epi,Sn,epi,Rnp and Nls are able to differentiate effectively the stomach carcinoma,stomach adenoma and normal stomach. The discriminative veracity were respectively 97.1%,87.5% and 100%; The parameters of Vvn,epi,Svn,epi,Vn,epiv,λepi and Rnp are able to differentiate effectively the well-differentiated,moderately-differentiated,poorly-differentiated stomach carcinoma and normal stomach, The discriminative veracity were respectively 53.3%,70%,95%和84.2%; The parameters of Vvn,epi和Svn,epi are able to differentiate effectively e well-differentiated,moderately-differentiated and poorly-differentiated stomach carcinoma, The discriminative veracity were respectively 46.7%,75%和95%.3. In practice, we believe in the diagnosis of discrimination in the stomach epithelial neoplasm can adopt the following steps:use first discrimination functions (7) to discriminate stomach carcinoma,stomach adenoma or normal stomach; Or use discrimination functions (8) distinction between the stomach carcinoma and normal stomach; use discrimination functions (9) distinction between the stomach adenoma and normal stomach; use discrimination functions (10) distinction between the stomach carcinoma and stomach adenoma; use discrimination functions (12) to discriminate the different grades stamach carcinoma.
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