Image analysis of nuclear/cytoplasmic ratio in cervical smears to discriminate three grades of cervical intraepithelial neoplasia.
OBJECTIVE
To suggest which system of cytologic classification (Bethesda System or World Health Organization [WHO]) of cervical lesions is more adequate for the Public Health Service of São Paulo State, Brazil, based on morphometric study with the Jandel Videoanalysis (JAVA) System.


METHODS
The study comprised groups of typical smears: cervical intraepithelial neoplasia (CIN 1) separated into two subgroups: cytopathic effects of human papillomavirus associated or not with dyskaryosis, CIN 2 and CIN 3. The JAVA system of image analysis was used to determine the nuclear/cytoplasmic (N/C) ratio in abnormal cells from each group.


RESULTS
Significant differences were detected between the three grades of CIN and between the two subgroups of CIN 1.


CONCLUSIONS
Although image analysis is not applicable to large-scale population screening of cervical smears, its use in the present study favored the three-grade cytologic classification (WHO). In addition, the three-grade classification offers the clinician more options for treatment. Considering the clinical-laboratory characteristics of our public health service, the three-grade classification is more adequate.
Maeda
M Y
MY
Division of Pathology, Adolfo Lutz Institute, São Paulo, Brazil.
Di Loreto
C
C
Shirata
N K
NK
Shih
L W
LW
Cavaliere
M J
MJ
Longatto Filho
A
A
Alves
V A
VA
D002467:Cell Nucleus / Q000473:pathology; D003593:Cytoplasm / Q000473:pathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000473:pathology; D014412:Tumor Virus Infections / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000145:classification* / Q000175:diagnosis*; D002578:Uterine Cervical Dysplasia / Q000145:classification* / Q000175:diagnosis*