UTILITY OF COMPUTERIZED MORPHOMETRY COMBINED WITH AGNOR STAINING IN DISTINGUISHING BENIGN FROM MALIGNANT PLEURAL EFFUSIONS

A study was designed to evaluate the usefulness of computer-aided imag e analysis in distinguishing benign from malignant pleural effusions. Morphometric measurements of preparations stained by the routine Leish man technique and quantitation of nucleolar organizer regions (AgNORs) were done on 65 cytologic samples randomly selected for the study and divided as follows: 30 samples from patients having benign pleural cy tology and 35 samples from patients with pleural malignancies. The fol lowing parameters were obtained: nuclear/cytoplasmic ratio (N/C); nucl ear and cytoplasmic area (NA and CA, respectively) and perimeter (NP a nd CP, respectively); major and minor nuclear diameter (DN and dN, res pectively); major and minor cytoplasmic diameter (DC and dC, respectiv ely); and absolute and fractional AgNOR (AgNOR/NA) area. Conformationa l characteristics of both nucleus (FFN) and cytoplasm (FFCy) were also computed. Statistical studies were done by means of discriminant anal ysis. The discriminant function generated from the morphometric data c orrectly diagnosed 100% of the cases. The validity of the classificati on provided by the function was tested by a jack knife (''one out'' pr ocedure), which again classified all the cases correctly. Our data sup port the concept that quantitative morphologic studies could be used i n the management of patients with pleural effusions.