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An Official Publication of the Indian Association of Oral and Maxillofacial Pathologists

Year : 2022  |  Volume : 26  |  Issue : 1  |  Page : 127
Perspective of nuclear fractal dimension in diagnosis and prognosis of oral squamous cell carcinoma

1 Department of Oral Pathology and Microbiology, Institute of Dental Sciences, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
2 Department of Computer Science and Engineering, Institute of Technical Education and Research, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
3 Department of Management, School of Commerce and Management, Central university of Rajasthan, Ajmer, India

Correspondence Address:
Swagatika Panda
Department of Oral Pathology and Microbiology, Institute of Dental Sciences, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar - 751 003, Odisha
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jomfp.jomfp_470_20

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Background: Owing to the restricted predictive value of conventional prognostic factors and the inconsistent treatment strategies, several oral squamous cell carcinoma (OSCC) patients are still over-treated or under-treated. In recent years, computer-assisted nuclear fractal dimension (nFD) has emerged as an objective approach to predict the outcome of OSCC. Objective: This study is an attempt to find out the differences in nFD values of epithelial cells of normal tissue, fibroepithelial hyperplasia, verrucous carcinoma, and OSCC. Further effort to evaluate the predictive potential of nFD of tumor cells for cervical lymph node metastasis (cLNM) was also assessed. Methodology: Formalin-fixed paraffin-embedded blocks of OSCC tissues of patients treated with neck dissection were collected. Photomicrographs of H-&E-stained sections were subjected to the image analysis by ImageJ and Python programming to calculate nFD. The association of categorical variables with nFD was studied using cross-tabulation procedure and the Fisher exact test. Receiver operating curve analysis was performed to find out cutoff value of nFD. A logistic regression model was developed to test the individual and combined predictive potential of grading and nFD for cLNM. Results: A significant difference between the mean nFD of healthy cells and malignant epithelial cells was observed (P = 0.01). nFD was not found to be an independent predictor of cLNM, although nFD and grading together demonstrated significant predictive potential (P = 0.004). Conclusion: nFD combined with grading can predict lymph node metastasis in OSCC. To the best of our knowledge, this is the first study of its kind.

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Journal of Oral and Maxillofacial Pathology | Published by Wolters Kluwer - Medknow
Online since 15th Aug, 2007