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      Computer-assisted morphometric image analysis of cells of normal oral epithelium and oral squamous cell carcinoma

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          Abstract

          Context:

          Oral squamous cell carcinoma (OSCC) is a malignant neoplasm of epithelial tissue origin. OSCC is traditionally graded into well, moderate and poorly differentiated. The assessment of cellular and nuclear features is very important in the histological grading of OSCC.

          Aims:

          To establish morphometric study as an important prognostic indicator of OSCC.

          Settings and Design:

          The present study is undertaken for computer-assisted morphometric evaluation of the following parameters: changes in cell perimeter, nuclear perimeter (NP), cell area (CA), nuclear area (NA) and nuclear-cytoplasmic ratio (N:C) in twenty cases of OSCC and ten cases of normal oral mucosa.

          Subjects and Methods:

          The hematoxylin- and eosin-stained sections were observed under microscope for dysplastic features. For morphometric analysis, images were captured with a 2MP camera attached to a NLCD 307 microscope (Lawrence and Mayo India Pvt., Ltd.,) with a ×40 objective used for morphometric analysis. The images were classified, transferred and stored in the computer for image analysis.

          Statistical Analysis Used:

          One-way analysis of variance is used for comparing the parameter for multiple groups followed by Mann-Whitney U-test for pair-wise comparisons.

          Results:

          Highly significant difference was seen between cases and controls with respect to CA, NP and NA. Highly significant difference is seen in N:C ratio between the means of cases and control groups.

          Conclusions:

          Techniques of image analysis offer an opportunity to quantify the nuclear and cell changes associated with malignancy and provide an objective basis for grading dysplasia and tumors.

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          Most cited references13

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          Cytomorphometric analysis of squames obtained from normal oral mucosa and lesions of oral leukoplakia and squamous cell carcinoma.

          Cell and nuclear diameters (CD and ND) were measured in squames obtained from normal buccal mucosa and lesions of oral leukoplakia and squamous carcinoma (SCC) also from buccal mucosa. The study groups consisted of Group 1: normal buccal mucosa (n = 40); Group 2: lesions with no epithelial dysplasia (n = 58); Group 3: lesions with epithelial dysplasia (n = 27); and Group 4: SCC lesions (n = 51). The mean CD and ND values were: Group 1: 51.78 (+/- 0.11) and 8.36 (+/- 0.49); Group 2: 45.73 (+/- 0.16) and 8.31 (+/- 0.68); Group 3: 41.32 (+/- 0.13) and 9.04 (+/- 0.46); Group 4: 38.58 (+/- 0.11) and 10.10 (+/- 0.56) microns, respectively. Correlation between the ND and CD was positive for Group 1 (r = 0.78, P < 0.05) and Group 2 (r = 0.33, P < 0.05). There were no significant correlations in Groups 3 and 4. ANOVA showed significant differences (P < 0.05) for CD between all four groups. Except between Groups 1 and 2, the ND was significantly different (P < 0.05) between all groups. The results indicate that ND and CD could possibly be sensitive parameters in the diagnosis of oral premalignant and malignant lesions.
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            Nuclear features in oral squamous cell carcinoma: A computer-assisted microscopic study

            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.
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              Morphometric analysis of basal cell layer in oral premalignant white lesions and squamous cell carcinoma.

              The size and shape of the cells in the basal cell layer of the oral epithelium in 100 specimens from oral mucosa were studied by using an interactive image analysis system (IBAS-1). Four groups of white lesions (traumatic keratosis, lichen planus, leucoplakia, and a "risk group") in addition to two control groups (normal mucosa and squamous cell carcinoma) were studied retrospectively. The results showed a progressive increase in the dimensions (area, perimeter, and maximum diameter) of the nuclei from normal mucosa through traumatic keratosis, lichen planus, leucoplakia and the "risk group" to carcinoma, with considerable differences. The nucleus in squamous cell carcinoma was twice as large as in normal mucosa. A substantial increase in the dimensions of both the cell and the nucleus was found in the "risk group." The nucleo:cytoplasmic ratio, contrary to what might have been anticipated in risk lesions, did not show considerable differences between the diagnostic groups. Furthermore, it was slightly decreased in the risk group compared with the normal mucosa. The shape factors (form PE and contour index) seemed to be less helpful in the identification of the "risk group." The size of the basal cell and its nucleus can be of diagnostic value for lesions with a high risk of malignant transformation.
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                Author and article information

                Journal
                J Oral Maxillofac Pathol
                J Oral Maxillofac Pathol
                JOMFP
                Journal of Oral and Maxillofacial Pathology : JOMFP
                Medknow Publications & Media Pvt Ltd (India )
                0973-029X
                1998-393X
                Jan-Apr 2017
                : 21
                : 1
                : 24-29
                Affiliations
                [1]Department of Oral Pathology and Microbiology, Buddha Institute of Dental Sciences and Hospital, Patna, Bihar, India
                Author notes
                Address for correspondence: Dr. Madhuresh Kumar, Department of Oral Pathology and Microbiology, Buddha Institute of Dental Sciences and Hospital, Patna - 800 020, Bihar, India. E-mail: dr.madhuresh25@ 123456gmail.com
                Article
                JOMFP-21-24
                10.4103/0973-029X.203760
                5406813
                dec48602-7f54-4c8b-a478-75251f982656
                Copyright: © 2017 Journal of Oral and Maxillofacial Pathology

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                : 26 September 2016
                : 28 December 2016
                Categories
                Original Article

                Pathology
                cell perimeter,morphometry,nuclear perimeter,nuclear-cytoplasmic ratio
                Pathology
                cell perimeter, morphometry, nuclear perimeter, nuclear-cytoplasmic ratio

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