title: Morphometrical differences between resectable and non-resectable pancreatic cancer: a fractal analysis.
abstract: OBJECTIVE
  Pancreatic cancer is a highly aggressive cancer with a rising incidence and poor prognosis despite active surgical treatment. Candidates for surgical resection should be carefully selected. In order to avoid unnecessary laparotomy it is useful to identify reliable factors that may predict resectability. Nuclear morphometry and fractal dimension of pancreatic nuclear features could provide important preoperative information in assessing pancreas resectability.
  
  
  METHODS
  Sixty-one patients diagnosed with pancreatic cancer were enrolled in this retrospective study between 2003 and 2005. Patients were divided into two groups: one resectable cancer group and one with non-resectable pancreatic cancer. Morphometric parameters measured were: nuclear area, length of minor axis and length of major axis. Nuclear shape and chromatin distribution of the pancreatic tumor cells were both estimated using fractal dimension.
  
  
  RESULTS
  Morphometric measurements have shown significant differences between the nuclear area of the resectable group and the non-resectable group (61.9 ± 19.8µm vs. 42.2 ± 15.6µm). Fractal dimension of the nuclear outlines and chromatin distribution was found to have a higher value in the non-resectable group (p<0.05).
  
  
  CONCLUSIONS
  Objective measurements should be performed to improve risk assessment and therapeutic decisions in pancreatic cancer. Nuclear morphometry of the pancreatic nuclear features can provide important pre-operative information in resectability assessment. The fractal dimension of the nuclear shape and chromatin distribution may be considered a new promising adjunctive tool for conventional pathological analysis.
authors.affiliation: Department of General Surgery, Fundeni Clinical Institute, Bucharest, Romania. catvasilescu@gmail.com
authors.forename: Catalin
authors.initials: C
authors.lastname: Vasilescu
authors.forename: Dana Elena
authors.initials: DE
authors.lastname: Giza
authors.forename: Petre
authors.initials: P
authors.lastname: Petrisor
authors.forename: Radu
authors.initials: R
authors.lastname: Dobrescu
authors.forename: Irinel
authors.initials: I
authors.lastname: Popescu
authors.forename: Vlad
authors.initials: V
authors.lastname: Herlea
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D018267:Carcinoma, Acinar Cell / Q000473:pathology* / Q000601:surgery*; D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology* / Q000601:surgery*; D002454:Cell Differentiation; D002467:Cell Nucleus / Q000473:pathology*; D053144:Cell Nucleus Shape; D053145:Cell Nucleus Size; D002843:Chromatin / Q000473:pathology; D005260:Female; D017709:Fractals; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D018579:Patient Selection; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012383:Romania
chemical_list: D002843:Chromatin