Urothelial carcinoma is the ninth most common cancer in the world. Cytological analysis of the urine is used for screening, as well as for cases suspected for neoplasia of the urinary tract. However, the sensitivity of urine cytology examination is low. The golden standard for diagnosing bladder cancer relies upon cystoscopy followed by a biopsy, which is microscopically assessed by the pathologist. Treatment decisions are based on the histological grade and stage of the tumor. Posttreatment tumor recurrence is 50%. The purpose of this study is to predict recurrence of urothelial carcinoma using a novel morphometric method of nuclear symmetry analysis. This method may help tailor the appropriate treatment and may reduce the need of invasive surgical procedures in patients. Computerized morphometry was applied to develop multiple symmetry indices of the nuclei of the tumor cells as follows: each nucleus was physically divided along its digital axis in two segments that were separately analyzed for their shape, size, optical density, and texture. Subsequently, ratios were obtained by mathematically dividing between the morphometric values of the two nuclear segments where the denominator contained the largest value of the two. These ratios were named symmetry indices and were included as variables to predict the recurrence time of the tumors. The change in the symmetry indices (loss of symmetry) of the nuclear roundness, fractal dimension and margination were the only independent predictors of recurrence time. Computerized morphometry of nuclear symmetry indices may help to predict tumor recurrence in urothelial carcinomas.

中文翻译：

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尿路上皮癌核对称性的形态学分析预测肿瘤复发

尿路上皮癌是世界上第九大最常见的癌症。尿液的细胞学分析用于筛查，以及疑似尿路肿瘤的病例。但尿细胞学检查的敏感性较低。诊断膀胱癌的黄金标准依赖于膀胱镜检查，然后是活检，病理学家对活检进行显微镜评估。治疗决定基于肿瘤的组织学分级和分期。治疗后肿瘤复发率为 50%。本研究的目的是使用核对称分析的新形态计量学方法预测尿路上皮癌的复发。这种方法可以帮助定制适当的治疗方法，并可以减少患者对侵入性外科手术的需求。计算机形态计量学被用于开发肿瘤细胞核的多个对称指数，如下所示：每个细胞核沿其数字轴物理分为两部分，分别分析它们的形状、大小、光密度和纹理。随后，通过在两个核段的形态测量值之间进行数学划分来获得比率，其中分母包含两者中的最大值。这些比率被命名为对称指数，并作为变量包括在内以预测肿瘤的复发时间。核圆度、分形维数和边缘的对称性指数（对称性丧失）的变化是复发时间的唯一独立预测因子。