Evaluating IPMN and pancreatic carcinoma utilizing quantitative histopathology

Evan S. Glazer, Hao Helen Zhang, Kimberly A. Hill, Charmi Patel, Stephanie T. Kha, Michael L. Yozwiak, Hubert Bartels, Nellie N. Nafissi, Joseph C. Watkins, David S. Alberts, Robert S. Krouse

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Intraductal papillary mucinous neoplasms (IPMN) are pancreatic lesions with uncertain biologic behavior. This study sought objective, accurate prediction tools, through the use of quantitative histopathological signatures of nuclear images, for classifying lesions as chronic pancreatitis (CP), IPMN, or pancreatic carcinoma (PC). Forty-four pancreatic resection patients were retrospectively identified for this study (12 CP; 16 IPMN; 16 PC). Regularized multinomial regression quantitatively classified each specimen as CP, IPMN, or PC in an automated, blinded fashion. Classification certainty was determined by subtracting the smallest classification probability from the largest probability (of the three groups). The certainty function varied from 1.0 (perfectly classified) to 0.0 (random). From each lesion, 180 ± 22 nuclei were imaged. Overall classification accuracy was 89.6% with six unique nuclear features. No CP cases were misclassified, 1/16 IPMN cases were misclassified, and 4/16 PC cases were misclassified. Certainty function was 0.75 ± 0.16 for correctly classified lesions and 0.47 ± 0.10 for incorrectly classified lesions (P = 0.0005). Uncertainty was identified in four of the five misclassified lesions. Quantitative histopathology provides a robust, novel method to distinguish among CP, IPMN, and PC with a quantitative measure of uncertainty. This may be useful when there is uncertainty in diagnosis.

Original languageEnglish (US)
Pages (from-to)2841-2847
Number of pages7
JournalCancer medicine
Issue number10
StatePublished - Oct 1 2016


  • Intraductal papillary mucinous neoplasms
  • karyometry
  • nuclear chromatin pattern
  • pancreatic carcinoma
  • quantitative histopathology

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research


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