Nielsen B, et al. - In the present study, researchers intended to create a way to detect nuclei with high chromatin entropy and assess the relationship between the presence of such deviating nuclei and prognosis. According to the findings, a novel method detected high–chromatin entropy nuclei; an increased proportion of such nuclei was correlated with poor prognosis. They found that chromatin entropy augmented existing prognostic markers in multivariable analyses of three gynecological cancer cohorts.

Methods

• For this analysis, the researchers developed a new texture-based biomarker that describes each cancer based on the proportion of high–chromatin entropy nuclei (< 25% vs ≥ 25%) on a discovery set of 175 uterine sarcomas.
• They assessed the prognostic impact of this biomarker on a validation set of 179 uterine sarcomas, and additionally on independent validation sets of 246 early-stage ovarian carcinomas and 791 endometrial carcinomas.
• The study involved more than 1 million images of nuclei stained for DNA, and all statistical tests were two-sided.

Results

• Study results showed that an increased percentage of high–chromatin entropy nuclei correlated with poor clinical outcome.
• Findings revealed that this biomarker forecast five-year overall survival for uterine sarcoma patients with a hazard ratio (HR) of 2.02 (95% confidence interval [CI]=1.43 to 2.84), time to recurrence for ovarian cancer patients (HR=2.91, 95% CI=1.74 to 4.88), and cancer-specific survival for endometrial cancer patients (HR=3.74, 95% CI=2.24 to 6.24).
• The present data indicated that chromatin entropy was an independent predictive marker in multivariable analyses with clinicopathological parameters (HR=1.81, 95% CI=1.21 to 2.70, for sarcoma; HR=1.71, 95% CI=1.01 to 2.90, for ovarian cancer; and HR=2.03, 95% CI=1.19 to 3.45, for endometrial cancer).