Image Quantification Analysis of Cytoplasmic Mucin and Interpretation of Mucin Color in Lobular Endocervical Glandular Hyperplasia.

Introduction: Although the widespread use of screening tests and HPV vaccines for squamous cell carcinoma has led to early detection and treatment, effectiveness is limited for cervical adenocarcinoma. Lobular endocervical glandular hyperplasia (LEGH) corresponds to gastric metaplasia but is regarded as a pathological condition with subtle morphological abnormalities. LEGH is a benign lesion and a precursor to gastric-type adenocarcinoma. We herein developed an objective and quantitative method by applying an image analysis technique to overcome the difficulties associated with the differential diagnosis of LEGH in uterine cervical cytology. This approach is expected to enable the early detection and accurate diagnosis of LEGH.

Methods: We extracted signal values for the nucleus and cytoplasm from microscopic images of cytological specimens of normal endocervical (EC) and LEGH cells. These values were then converted into CIELAB and sRGB values to create color distribution maps, and color unmixing techniques were applied to assess the spectral absorbance of each pigment.

Results: The CIELAB signal values extracted from the nuclear images of LEGH cells exhibited lower values than those of EC cells. Furthermore, based on color distribution maps, the cytoplasm of EC cells exhibited shades from purple to pink, while LEGH cells showed a distribution toward yellow.

Conclusions: This study reveals that, compared to EC cells, LEGH cells exhibit lower nuclear signal values and increased nuclear chromatin content. Thus, assessing the relative difference in cytoplasmic color tones between them may become an effective indicator for distinguishing between EC and LEGH cells.