Preprint Article Version 1 This version is not peer-reviewed

Fractal Dimension Analysis of the Tumor Microenvironment in Cutaneous Squamous Cell Carcinoma: Insights into Angiogenesis and Immune Cell Infiltration

Version 1 : Received: 5 September 2024 / Approved: 6 September 2024 / Online: 9 September 2024 (12:44:38 CEST)

How to cite: Buruiană, A.; Șerbănescu, M.-S.; Pop, B.; Gheban, B.-A.; Gheban-Roșca, I.-A.; Hendea, R. M.; Georgiu, C.; Crișan, D.; Crișan, M. Fractal Dimension Analysis of the Tumor Microenvironment in Cutaneous Squamous Cell Carcinoma: Insights into Angiogenesis and Immune Cell Infiltration. Preprints 2024, 2024090567. https://doi.org/10.20944/preprints202409.0567.v1 Buruiană, A.; Șerbănescu, M.-S.; Pop, B.; Gheban, B.-A.; Gheban-Roșca, I.-A.; Hendea, R. M.; Georgiu, C.; Crișan, D.; Crișan, M. Fractal Dimension Analysis of the Tumor Microenvironment in Cutaneous Squamous Cell Carcinoma: Insights into Angiogenesis and Immune Cell Infiltration. Preprints 2024, 2024090567. https://doi.org/10.20944/preprints202409.0567.v1

Abstract

The global incidence of cutaneous squamous cell carcinoma (cSCC), a prevalent and aggressive skin cancer, has risen significantly, posing a substantial public health challenge. This study investigates the tumor microenvironment (TME) of cSCC by focusing on the spatial distribution patterns of immune and vascular markers (CD31, CD20, CD4, and CD8) using fractal dimension (FD) analysis. Our analysis encompassed 141 cases, including 100 invasive cSCC and 41 specimens with pre-invasive lesions exclusively, and the rest being peripheral pre-invasive lesions from the invasive cSCC class. The FD values for each marker were computed and compared between pre-invasive and invasive lesion classes. The results revealed significant differences in FD values between the two classes for CD20 and CD31 markers, suggesting distinct alterations in B cell distribution and angiogenic activity during cSCC progression. However, CD4 and CD8 markers did not exhibit significant changes individually. Still, the CD4/CD8 ratio showed a significant difference, indicating a potential shift in the immune landscape as lesions progress from pre-invasive to invasive stages. These findings underscore the complexity and heterogeneity of the TME in cSCC and highlight the potential of FD analysis as a quantitative tool for characterizing tumor progression. Further research is needed to elucidate the implications of these differences in the clinical management of cSCC.

Keywords

fractal dimension; cutaneous squamous cell carcinoma; digital image analysis; tumor microenvironment; angiogenesis; immune cells

Subject

Medicine and Pharmacology, Pathology and Pathobiology

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