USE OF CELL IMAGE-ANALYSIS IN THE DETECTION OF CANCER FROM SPECIMENS OBTAINED DURING ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY

The authors report a scoring system based on cell image analysis of sp ecimens obtained during endoscopic retrograde cholangiopancreatography from either the biliary or pancreatic duct epithelium. Nine normal, 2 0 inflammatory, and 19 malignant epithelia were assessed using a cell- image processor that permits determination of morphometric (nuclear ar ea), densitometric (nuclear DNA content), and textural (chromatin dist ribution) parameters on Feulgen-stained nuclei. The score is based on three densitometric parameters: the DNA histogram type, the nuclear DN A content, and the percent proliferating cell population. These parame ters permit distinction of normal and inflammatory from malignant epit helium with 95% sensitivity and 100% specificity. Cell-image analysis of specimens obtained during endoscopic retrograde cholangiopancreatog raphy is a useful clinical tool in the detection of malignant lesions of the pancreas and biliary epithelia.