Nuclear textures of oral mucosal cells were quantitated by image analysis, and their suitability as markers in a chemopreventive trial explored. Subjects were chewers of tobacco-containing betel quids with well established
oral leukoplakias. Treatment consisted of a weekly
oral administration of
vitamin A (200,000 IU/week) for six months.
Leukoplakias regressed in 57.1% of the 21 trial participants. The original
leukoplakias did not redevelop within four months after termination of treatment. For image analysis, biopsies were taken from
leukoplakias of five chewers before administration of
vitamin A, at the end of the administration, and four months after termination of treatment. Sections of
paraffin-embedded biopsies were stained with the Feulgen reaction and submitted to quantitative image analysis of two parameters: variance of intensity and entropy. Both these parameters were significantly reduced in all five trial participants as a result of the six-month
vitamin A treatment. During the post-treatment period, nuclei with condensed
chromatin, as measured by the variance of intensity, reappeared in the mucosa of four of the five chewers examined, although no
leukoplakias were detectable on visual examination of the oral cavity. The results indicate that the quantitation of nuclear textures in a small subpopulation of a chemopreventive trial could conceivably be a simple marker with a predictive value.