Nuclear morphometry identifies a distinct aggressive cellular phenotype in cutaneous squamous cell carcinoma

Area of Science:

• Oncology
• Dermatopathology
• Quantitative Pathology

Background:

• Cutaneous squamous cell carcinoma (cSCC) poses a risk of recurrence and secondary tumors, necessitating accurate prognostication.
• Identifying aggressive cSCC aids in targeted surveillance and therapy, potentially reducing patient morbidity and mortality.

Purpose of the Study:

• To investigate the utility of nuclear morphometry (karyometry) in distinguishing between aggressive and nonaggressive cSCC.
• To develop a quantitative classification score for risk stratification of cSCC patients.

Main Methods:

• Retrospective analysis of cSCC lesions from 40 male patients, categorized as aggressive (22) or nonaggressive (18).
• Karyometric analysis was performed to identify nuclear features differentiating cSCC subtypes.
• A quantitative aggressive classification score was derived using statistically significant nuclear features (Kruskal-Wallis test, P < 0.0001).

Main Results:

• A mean of 96 nuclei were analyzed per group.
• The mean classification score was significantly higher for aggressive cSCC (69% ± 6%) compared to nonaggressive cSCC (28% ± 5%, P = 0.00002).
• The classification score accurately categorized 80% of patients (P = 0.0004), demonstrating significant discriminatory power.

Conclusions:

• Karyometry effectively differentiates between aggressive and nonaggressive cSCC.
• The derived classification score offers a quantitative measure for individual lesion assessment.
• This quantitative approach holds promise for improving risk stratification in patients with cSCC.