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Nuclear texture: can it be used as a surrogate endpoint biomarker?

Nuclear texture measurements are suggested to predict the progression/regression of precancerous lesions in breast, cervix, lung, and possibly other tissues. Nuclear texture features describe DNA distribution patterns in cell nuclei, and can be reliably measured by high resolution image cytometry, both in tissue sections as well as in single cell preparations such as smears from fine needle aspirates (FNAs) or cell suspension preparations. The cells must be stained with a stoichiometric DNA stain. For absorbance staining, the Feulgen-Thionin stain is one of the best performers used for DNA ploidy measurements using conventional image cytometry. Regression/progression information can be obtained from either diagnostic cell nuclei or from cell nuclei of normal surrounding tissue. Subtle changes in normal-appearing cells adjacent to malignant tumors are called malignancy associated changes (MACs) and can be detected by nuclear texture measurements. We postulate that measurements of texture features can also be employed as surrogate endpoint biomarkers (SEBs).