The fractal dimension of chromatin - a potential molecular marker for carcinogenesis, tumor progression and prognosis.

INTRODUCTION: Fractality is omnipresent in medicine and life sciences. In particular, the fractal principle is found simultaneously at different organization levels of the cell nucleus. The aim of this review is to show whether fractal characteristics of chromatin could be related to tumor pathology and pathophysiology. Areas covered: This review provides an overview of the application of fractal measurements of chromatin or DNA for the characterization of physiological or pathological processes, in particular for the detection of preneoplastic changes, the characterization of tumor progression, the differential diagnosis between neoplasms and for prognosis. We used a network-based literature research strategy, i.e. after a systematic investigation by key-words, we looked for all citations (and the citations to these citations) of the selected papers in Scopus and Webofscience. Expert opinion: The fractal dimension (FD) increases during carcinogenesis, thus permitting the diagnosis of malignancy. In various malignant tumors, a higher FD or diminished goodness-of-fit of its regression line indicates a more aggressive behavior and worse prognosis. Applying new spectral techniques, the chromatin FD can be estimated at scales below the light microscopic resolution. The latter also permits the examination of live cells and studies on field carcinogenesis and chemoprophylaxis.