Application of Feulgen staining morphological and texture features in missed diagnosis cases related to cervical hyperchromatic crowded groups
DU Bohai
FU Siying
XIAO Shanshan
TANG Yijia
LI Weiling
KUANG Zhongsheng
Abstract：Objective To analyze the morphological characteristics and improvement strategies of missed diagnosis cases in cervical cytology,and to explore the application value of Feulgen staining combined with texture analysis in the diagnosis of hyperchromatic crowded groups(HCGs).Methods A total of 80,138 cervical sedimentation-based liquid-based cytology samples from June 2019 to June 2024 were retrospectively collected.Twelve cases of thick-layer HCG-related missed diagnosis were selected as the missed diagnosis group;100 benign cases were matched as the negative control group,and 20 high-grade squamous intraepithelial lesion(HSIL)cases as the positive control group.Feulgen staining was performed on the deparaffinized and decolorized smears or residual samples of the missed diagnosis group and part of the control groups.The characteristics of the two staining methods were observed and recorded,and the morphological features of HCGs were summarized.A texture analysis method was established based on the ImageJ platform.The texture indicators of the three groups were detected using the single-blind method,and the texture parameters were compared with SPSS software.Results Under Papanicolaou staining,HCGs could be classified into four types according to the risk of missed diagnosis,and key indicators to focus on included nuclear membrane morphology,nucleoli,nuclear chromatin contrast,homogeneity,and nuclear arrangement.The comparative experiments showed that Feulgen staining could better reveal the cell nuclei of HCGs,making observation more convenient.Texture analysis revealed significant differences in contrast and other indicators between the positive group/missed diagnosis group and the negative group.Combining morphological analysis with texture indicators could improve the diagnostic accuracy for difficult HCG cases.Conclusion Feulgen staining and texture analysis can assist in determining the benign or malignant nature of cervical HCGs.When there are difficulties in HCG diagnosis,the combination of morphology,Feulgen staining and texture analysis can improve the diagnostic accuracy of cervical liquid-based cytology with low cost.
Keywords：CervixGray-level co-occurrence matrixFeulgen stainingHSILHyperchromatic crowded groups
Publication Date：2025-10-28
Online Publishing Date：2025-11-06(First online date of this platform, not the publication date of the document)
Pages：6( 1243-1248 )