The Role of Cell Detection Tool of QuPath-0.3.2 Software in Differentiating Benign Cervical Epithelium from Malignant Epithelial Clusters

Aim: The study aims to be an initial assessment of the ability of the Qu Path software to quantitatively distinguish between benign cervical epithelium and non-keratinizing squamous cell carcinoma cell clusters.

Study Design: We carried out a retrospective cross-sectional study of nineteen slides of cervical biopsies of non-keratinizing squamous cell carcinoma (NKSCC) of the cervix.

Place and Duration of Study: These are from cases of cervical carcinomas seen in UniOsun Teaching Hospital, Osogbo between 1st January 2006 and 31st December 2015.

Materials and Methods: These slides had been prepared by standard laboratory protocol and stained with hematoxylin and eosin. The slides were scanned using CS2 APERIO digital slide scanner with standard settings.

The scanned slides were viewed using QuPath-0.3.2 software. For each normal or NKSCC cell found in the randomly sampled cluster of the biopsy, the nuclear and cytoplasmic morphometric features were analyzed using Microsoft Excel and SPSS version 20.

Results: The cells in the normal clusters were 13,774 and that of the NKSCC was 26,114. There is a higher mean nuclear area in NKSCC cells compared to normal cells. The malignant cells have a higher mean nuclear area, circularity, and perimeter than cells of the benign epithelium. There was a higher nuclear hematoxylin OD (optic density) mean, hematoxylin OD max, and hematoxylin OD sum in the malignant cells. There was a higher cell eccentricity, mean cytoplasmic eosin OD, maximum eosin OD and minimum eosin OD in the malignant cells. The maximum nuclear caliper is higher in cells of NKSCC than that of benign epithelium.

Conclusion: The QuPath software (version 0.3.2) can be a useful aid to differentiate non-keratinizing squamous cell carcinoma (NKSCC) from normal squamous cervical epithelium especially in fragmented biopsies.