Discrimination of various epithelia by simple morphometric evaluation of the basal cell layer. A light microscopic analysis of pseudostratified, metaplastic and dysplastic nasal epithelium in nickel workers

This study presents a simple morphometric method for objective classification of pseudostratified, various types of metaplastic, and dysplastic epithelium by evaluation of cellular features in the basal layer only. Fifty-four biopsy specimens were taken for diagnostic reasons from the nasal mucosa of nickel workers, and semithin toluidine-blue-stained sections were analysed. The most sensitive parameters in distinguishing between the various types of epithelium were: (i) the transverse nuclear diameter, (ii) the size of the nucleoli and (iii) the basal cell width expressed as an index weighted towards the cell profiles with the broadest attachment face on the basal lamina. A combination of these three parameters allows a clear separation between dysplastic, metaplastic and pseudostratified epithelium. The sequential increase in these parameters from pseudostratified epithelium through two histologically distinguishable stages of metaplasia (stratified cuboidal and mixed stratified cuboidal/stratified squamous epithelium) to fully developed squamous epithelium supports the concept that metaplasia develops gradually. The continuous increase in these parameters from metaplasia to dysplasia further suggests that metaplasia is a necessary step in the development of nasal epithelial dysplasia. This morphometric model appears especially useful in monitoring small sequential epithelial changes, and might also be used for evaluating other types of epithelia.