Nuclear features in oral squamous cell carcinoma: A computer-assisted microscopic study

Abstract

Background and Objectives:Oral squamous cell carcinoma (OSCC) is one of the most common tobacco-related cancers affecting the Indian population. Various malignancy-grading systems based on different histopathological features have been proposed for OSCC. Due to inherent subjectivity, inter-observer variation and reproducibility of a grading system remains a problem. Grading systems based on nuclear morphometry have been proposed for laryngeal, renal and pharyngeal carcinomas. In this study, an attempt was made to grade oral OSCC based on computer-assisted microscopic evaluation of nuclear features. Our intention was also to evaluate the use of Feulgen stain for studying nuclear features.Materials and Methods:Sections made from buccal mucosa biopsies of normal mucosa as well as different grades OSCC were stained by Feulgen reaction. The nuclear features were evaluated by computer-assisted microscopic image analysis for nuclear area (NA), nuclear perimeter (NP) and nuclear form factor (NF) and correlated with histologic grading of OSCC. Nuclear shape, membrane outline, chromatin clumps, nucleoli, and abnormal mitoses were also evaluated.Results:NA and NP were observed to be significantly increased in OSCC (P < 0.001) when compared with the control group. These values increased in correlation with increasing grades of OSCC. However, NF was found to more in the control group (P < 0.001).Conclusion:It may be concluded from the results that computer-assisted nuclear morphometry is a reliable tool for grading OSCC. A new grading system based on nuclear features for OSCC has been proposed.

Cancer Cell Nucleus: An Insight

“…Multinucleation is also commonly observed feature in malignancy [4]. The presence of micronuclei is also known to correlate with the grades of carcinoma.…”

“…Irregularity of membrane has been shown to increase with increasing grades of carcinoma (Figure 4) [4]. It may be seen as nuclear grooving, nuclear molding, and nuclear convolutions or irregular thickening of nuclear margin [6].…”

“…Studies in different types of cancers have shown that the nuclear area and perimeter increase gradually with increasing grades of carcinoma [1][2][3][4].…”

“…In cancer, nuclei can become irregular or elliptical with coarse heterochromatin aggregates ( Figures 3 and 4) [4]. Increased fragmentation or budding of nuclei, ring-shaped nuclei, and nuclear holes are often noted in cancer nuclei as well [5].…”

“…Increased fragmentation or budding of nuclei, ring-shaped nuclei, and nuclear holes are often noted in cancer nuclei as well [5]. Profound anisonucleosis is evident in high grade tumors [4,6].…”