Nuclear morphology explained through digital morphometry: differentiating nuclear features across the three histological grades in cutaneous squamous cell carcinoma.

Introduction: The accurate grading of cutaneous squamous cell carcinoma (cSCC) is crucial for effective treatment and patient care, but the current method, relying on pathologist visual assessment, can be subjective.

Aim: This study aimed to quantitatively investigate nuclear morphometrics in cSCC tumor cells, specifically examining potential differences between established histological grades and exploring the utility of digital morphometrics in characterizing nuclear morphology.

Materials and methods: We analyzed 47 cSCC cases, utilizing whole slide images and CellProfiler software to extract nuclear morphometric features from a total of 519 828 nuclei.

Results: The results showed significant differences in nuclear size, shape, and spatial arrangement between different tumor grades. Notably, grade 3 tumors exhibited distinct characteristics compared to grades 1 and 2, suggesting a potential shift towards a simplified, 2-tier grading system.

Conclusions: The study highlights the potential of digital morphometrics as a valuable tool for enhancing the accuracy and objectivity of cSCC grading, ultimately improving patient care.