title: Karyometry of nuclei from actinic keratosis and squamous cell cancer of the skin.
abstract: OBJECTIVE
  To use karyometric analysis methods to compare actinic keratoses (AKs) to squamous cell carcinomas (SCCs) to determine if SCCs showed a logical progression beyond that seen in AKs and to explore variability within and between lesion types to better understand distinctions between the 2.
  
  
  METHODS
  Biopsies from 31 subjects with AKs were obtained from upper inner arm skin, forearm skin and AK lesions. Biopsies from 23 different subjects in a related subproject provided SCC biopsies for comparison.
  
  
  RESULTS
  Karyometric measures of nuclear abnormality and sun damage were derived. Mean actinic damage levels progressed logically from inner arm to sun-exposed skin, to AK, to SCC. Considerable heterogeneity existed at the case level. Unsupervised learning methods revealed 2 distinct clusters of progressed lesions with different nuclear signatures, reflecting differing levels of actinic damage. Number of AKs and SCCs and invasiveness and differentiation of SCCs were distributed across both clusters in roughly equivalent proportions.
  
  
  CONCLUSIONS
  Karyometric methods, shown previously to be capable of sensitively detecting subtle nuclear changes, revealed the possibility of 2 progression pathways, each containing AKs and SCCs. This finding may have prognostic implications.
authors.affiliation: College of Public Health, Arizona Cancer Center, University of Arizona, Tucson, AZ 85721, USA. jrangerm@azcc.arizona.edu
authors.forename: James
authors.initials: J
authors.lastname: Ranger-Moore
authors.forename: Paul
authors.initials: P
authors.lastname: Bozzo
authors.forename: David
authors.initials: D
authors.lastname: Alberts
authors.forename: Janine
authors.initials: J
authors.lastname: Einspahr
authors.forename: Yun
authors.initials: Y
authors.lastname: Liu
authors.forename: Deborah
authors.initials: D
authors.lastname: Thompson
authors.forename: Steven
authors.initials: S
authors.lastname: Stratton
authors.forename: M Suzanne
authors.initials: MS
authors.lastname: Stratton
authors.forename: Peter
authors.initials: P
authors.lastname: Bartels
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D002467:Cell Nucleus / Q000473:pathology*; D016002:Discriminant Analysis; D018450:Disease Progression; D005260:Female; D006801:Humans; D007620:Karyometry; D007642:Keratosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000473:pathology*