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目的：利用普通病理切片的形态参数评测胆管癌神经浸润情况，推测患者生存中位时间。方法：利用图像分析技术，从胆管癌细胞、细胞核、核仁三个层次，对４０例高、中、低分化及乳头状腺癌病理标本的细胞截面积、等效直径、细胞形状因子、核浆比、核面积、核形状因子、ＡｇＮＯＲｓ记数等７个形态计量学参数进行测量。结果：中、低分化腺癌的神经周围浸润指数（ＰＮＩ）大于０７０，属于严重性神经浸润。建立了ＰＮＩ与生存中位时间和与细胞形态计量学参数的数学模型。ＰＮＩ与生存中位时间呈负相关，而与除细胞截面积外的６个参数呈正相关。结论：（１）胆管癌的ＰＮＩ值反映了胆管癌的生物学特性，对判断预后有重要价值。（２）细胞、细胞核、核仁三个层次的形态计量学参数中，后二者与ＰＮＩ相关性更好。（３）应用数学模型可以判断胆管癌的神经浸润情况，并推测患者的生存中位时间。
Objective: To evaluate the neurological invasion of cholangiocarcinoma using morphological parameters of normal pathological sections and to infer the median survival time of patients. METHODS: Using image analysis techniques, cell cross-sectional areas, equivalent diameters, cell shape factors, and nucleus in 40 high-, medium-, poorly-differentiated, and papillary adenocarcinoma specimens from the three levels of cholangiocarcinoma cells, nucleus, and nucleoli were examined. Seven morphometric parameters such as the ratio of pulp, nuclear area, nuclear shape factor, and AgNORs were measured. Results: Peripheral infiltration index (PNI) of moderately and poorly differentiated adenocarcinoma was greater than 070, and it was a severe nerve infiltration. A mathematical model for PNI and median survival time and cell morphometric parameters was established. PNI was negatively correlated with median survival time, but positively correlated with 6 parameters except cell cross-sectional area. Conclusion: (1) The PNI value of cholangiocarcinoma reflects the biological characteristics of cholangiocarcinoma and is of great value in determining the prognosis. (2) Among the morphometric parameters in the three levels of cells, nucleus and nucleoli, the latter two are more related to PNI. (3) Mathematical model can be used to judge the neural invasion of cholangiocarcinoma, and the median survival time of patients is estimated.