Journal of Contemporary Dentistry

Register      Login

VOLUME 7 , ISSUE 2 ( May-August, 2017 ) > List of Articles


Evaluation of Nuclear Morphometry in Oral Squamous Cell Carcinoma: A Retrospective Study

Niharika Swain, Shilpa Patel, Jigna Pathak, Nikitha Narayanan

Citation Information : Swain N, Patel S, Pathak J, Narayanan N. Evaluation of Nuclear Morphometry in Oral Squamous Cell Carcinoma: A Retrospective Study. J Contemp Dent 2017; 7 (2):107-113.

DOI: 10.5005/jp-journals-10031-1195

License: CC BY 3.0

Published Online: 01-08-2017

Copyright Statement:  Copyright © 2017; The Author(s).



To evaluate and compare various nuclear morphometric parameters in different histopathological grades of oral squamous cell carcinoma (OSCC) by using computerized image analysis and also to correlate it with regional lymph node metastasis.

Materials and methods

This retrospective study was conducted on paraffin blocks of 40 tissue specimens of OSCC cases treated with neck dissection, which were retrieved from the archives of the Department of Oral Pathology and Microbiology, Mahatma Gandhi Mission’s Dental College and Hospital, Navi Mumbai, India. All cases were histopathologically graded as well, moderately, and poorly differentiated OSCC. Further, they were also categorized based on pathological lymph node status as with or without lymph node metastasis. Sections from tumor proper were subjected to Feulgen nuclear staining technique. Images of 10 microscopic fields at the deepest invading part of tumor were captured randomly and 100 nuclei of tumor cells with clear, complete, nonoverlapping outlines were selected in each case. Nuclear morphometric parameters, such as large diameter, small diameter, nuclear area, and nuclear perimeter were measured for each of the 100 cells.


An increase in mean nuclear area coefficient of variation (NACV) was observed in OSCC cases with lymph node metastasis pN(+) than in those without lymph node metastasis pN(–), (p = 0.67). A significant increase in nuclear area and perimeter was observed in pN(+) cases (p < 0.01). A significant decrease in circular rate and increase in largest to smallest nuclear diameter (L/S) ratio (p < 0.01) was observed in pN(+) cases. On comparing the nuclear morphometric parameters with different histopathological grades of OSCC, we found an increase in mean NACV values from well-differentiated OSCC to moderately differentiated and poorly differentiated OSCC (p = 0.612). An increase in mean nuclear area and perimeter was noted as grades of OSCC advanced (p > 0.01). The mean circular rate was found to be lowest in poorly differentiated OSCC (p = 0.362). A significant increase in mean L/S ratio was observed within different histopathological grades of OSCC (p = 0.044), which when further confirmed using least significant difference (LSD) post hoc test, indicated a difference only between well-differentiated and poorly differentiated cases of OSCC (p = 0.132).


Our observations reveal that tumor cells with greater nuclear dimension and more elliptical shape tend to show increased incidence of nodal metastasis. Also, a positive inclination was observed in nuclear size and shape with increasing histopathological grades of OSCC. However, our data warrant a large-scale study to establish nuclear morphometry as a quantitative objective parameter and also for the rational application of the same.

How to cite this article

Narayanan N, Pathak J, Patel S, Swain N. Evaluation of Nuclear Morphometry in Oral Squamous Cell Carcinoma: A Retrospective Study. J Contemp Dent 2017;7(2):107-113.

  1. Current aspects on oral squamous cell carcinoma. Open Dent J 2012 Aug;6:126-130.
  2. ; Pisani, P.; Parkin, DM. GLOBOCAN 2002. Cancer incidence, mortality and prevalence worldwide. IARC Cancer Base. Lyon: IARC Press; 2004.
  3. Molecular pathogenesis of oral squamous carcinoma. Mol Pathol 2000 Aug;53(4):165-172.
  4. Role of Toulidine blue in early detection of oral cancer. Pak J Med Sci 2006 Jun;22(2):184-187.
  5. Global epidemiology of oral and oropharyngeal cancer. Oral Oncol 2009 Apr-May;45(4-5):309-316.
  6. Molecular pathogenesis of oral squamous cell carcinoma: implications for therapy. J Dent Res 2008 Jan;87(1):14-32.
  7. An image analysis study on nuclear morphology in metastasized and non-metastasized squamous cell carcinomas of the tongue. J Pathol 1998 Jun;185(2):175-183.
  8. Prediction of lymph node metastases by preoperative nuclear morphometry in oral squamous cell carcinoma: a comparative image analysis study. Indian J Cancer 2010 Oct-Dec;47(4):406-411.
  9. Mode of invasion and lymph node metastasis in squamous cell carcinoma of the oral cavity. Head Neck Surg 1984 May-Jun;6(5):938-947.
  10. Nuclear morphometry in squamous cell carcinoma of the tongue. Eur J Cancer B Oral Oncol 1996 Mar;32B(2):91-96.
  11. Precision of histological grading of malignancy. APMIS Sect A Pathol 1980 Jul;88A(1-6):307-317.
  12. Image analysis and definition of nuclear phenotypes. Braz J Genet 1997 Dec; 20(4):749-754.
  13. Quantitative study of ductal breast cancer progression: Signatures of nuclei in proliferating breast lesions and in situ cancers. Adv Clin Pathol 2000 Apr;4(2):87-97.
  14. ; Eveson, JW.; Reichart, P.; Sidransky, D. World Health Organization Classification of Tumors. International Agency for Research on Cancer (IARC). Pathology and genetics head and neck tumours. Lyon: IARC Press; 2005. p. 168-169.
  15. 2009. Available from:
  16. Clinicopathologic parameters in predicting cervical nodal metastasis in early squamous cell carcinoma of the oral cavity. Kurume Med J 1993 Aug;40(4):183-192.
  17. Oral squamous cell carcinoma: review of prognostic and predictive factors. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006 Jul;102(1):67-76.
  18. Growth disorders and Neoplasia. In: Essential pathology for dental students. 3rd ed. India: Jaypee; 2005. p. 364-366.
  19. A new morphologic assessment for advanced gastric adenocarcinoma. Ann Surg 1999 Jan;229(1):55-61.
  20. Applicability of preoperative nuclear morphometry to evaluating risk for cervical lymph node metastasis in oral squamous cell carcinoma. PLoS One 2014 Dec;9(12):e116452.
  21. Morphometry of gastric carcinoma: its association with patient survival, tumor stage and DNA ploidy. J Pathol 1992 Oct;168(2):201-208.
  22. Computerized nuclear morphometry is a useful technique for evaluating the high metastatic potential of colorectal adenocarcinoma. Cancer 1999 Nov;86(10):1944-1951.
  23. Nuclear morphometry for the prediction of regional lymph nodes metastases in patients with cancer of the larynx. Otolaryngol Head Neck Surg 2000 Dec;123(6):770-774.
  24. Correlation of nuclear morphometry with progression of breast cancer. Cancer 1991 Nov;68(9):2012-2016.
  25. Predictability of lymph node metastases by preoperative nuclear morphometry in squamous cell carcinoma of the tongue. Cancer Detect Prev 2003;27(6):427-433.
  26. A fixed site of DNA replication in eucaryotic cells. Cell 1980 Feb;19(2):527-536.
  27. Supercoiled loops and eucaryotic DNA replication. Cell 1980;22(1):79-85.
  28. Insights into the mechanisms of lymph node metastasis. Cancer 2003 Jul;98(2):413-423.
  29. Nuclear features in oral squamous cell carcinoma: a computer assisted microscopic study. J Oral Maxillofac Pathol 2011 Sep;15(2):177-181.
  30. Cancer as a disease of DNA organization and dynamic cell structure. Cancer Res 1989 May;49(10):2525-2532.
  31. Classification strategies for the grading of renal cell carcinomas, based on nuclear morphometry and densitometry. J Pathol 1997 Oct;183(2):141-150.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.