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      Nº 012

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Automatic Histomorphometric Evaluation by Digital Image Analysis in Patients with Diabetes Mellitus Type I.


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esp.gif (219 bytes) [Título] [Introducción] [Material y Métodos] [Resultados] [Discusión] [Iconografía] [Bibliografía]

Francisco O'Valle, MD.
Francisco O'Valle*, Marco Masseroli*, Raimundo G. Del Moral*, Raimundo G.M. Del Moral*, Rafael Cárvia*, José Bronsoms, Martín Vallés, Juan M. Mauri.

*Department of Pathology, School of Medicine and University Hospital, University of Granada, 18012 Granada, Spain Nephrology Service, J. Trueta University Hospital, Girona - Spain

 fovalle@goliat.ugr.es

Dpto. de Anatomía Patológica, Facultad de Medicina, Avda. de Madrid 11 - 18012 Granada, SPAIN

 

BACKGROUND: Diabetic nephropathy is characterized by the appearance of glomerular, interstitial and vascular lesions that initially induce no measurable renal dysfunction. In insulin-dependent Diabetes Mellitus (IDDM) one of the most important morphologic changes is produced in basal membranes. The aim of this study is to quantitatively and automatically evaluate these early changes and to establish possible differences between patients with and without albuminuria.

MATERIAL AND METHODS: We studied 23 renal biopsies from patients diagnosed with IDDM (15 without albuminuria [IDDMNA] and 8 with [IDDMA]) and 8 control renal biopsies. Sections stained with Sirius red and immunostained for collagen IV were quantified using the image analysis application Fibrosis HR® (Master Diagnóstica S.A., Granada, Spain). This method automatically extracts the morphologic areas of interest according to the stained zones, and automatically quantifies interstitial, periglomerular and mesangial expansion and the dimensions of tufts and glomeruli. The resulting morphometric values are expressed as percentages and in µm².

RESULTS AND DISCUSSION: Some of the results obtained can be seen in the table. We highlight the great ability of this technique to identify structural changes in incipient diabetic nephropathies. In particular, the percentage of periglomerular fibrosis and the glomerular area significantly discriminate between patients with IDDMNA and those with IDDMA (Newman-Keuls, p<0.01). The results for collagen IV are generally similar but with less significance, above all for the quantification of glomerular structures.

Sirio Red Stain

% Total Fibrosis

% Interstitial Fibrosis

% Periglomerular Fibrosis

Mesangial Area (µm²)

Glomerular Area (µm²)

IDDMNA

26.0±5.8

20.9±5.0

35.1±7.9

3876.2±3283.0

18772.0±3896.8

IDDMA

28.7±4.2

22.1±2.5

41.8±7.0

4951.2±2757.1

24583.5±5358.5

Control

17.2±2.9

12.9±2.5

24.6±3.3

1050.3±734.6

18967.5±3072.1

ANOVA

p<0.001

p<0.001

p<0.001

p<0.05

p<0.01

CONCLUSION: The methodology we used allowed the identification and quantification of early renal lesions in IDDM, and may be of great utility to control the progression of this disease.

 

 

Key Words: Diabetes Mellitus, Kidney, Collagen IV, Image Processing, Automatic quantification, Morphologic quantification.

 

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Francisco O'Valle is Assistant Professor of the Pathology Department of the School of Medicine, University of Granada. His main research line is on drug multiresistance in experimental models.

 

We look forward to seeing you at The Twenty-Second Annual Course on the Surgical Pathology of Neoplastic Diseases organized by the Memorial Sloan-Kettering Cancer Center in Granada (May 1999).

F. O'Valle, MD.


Francisco O'Valle, MD.
Copyright © 1996, Departamento de Anatomía Patológica, Facultad de Medicina y Hospital Universitario, Universidad de Granada, 18012 Granada, España. Reservados todos los derechos.

 

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