title: Karyometric image analysis for intraepithelial and invasive cervical lesions.
abstract: OBJECTIVE
  To derive an objective, numeric measure for the progression of intraepithelial and invasive squamous cell cervical lesions.
  
  
  METHODS
  Thin-layer cervical cytology preparations from colposcopically confirmed normal cervix, low grade squamous intraepithelial lesions, high grade squamous intraepithelial lesions and carcinoma were identified from a cross-sectional study. Fifty-nine cases representing 4 diagnostic categories were selected, and 2,375 nuclei from epithelial cells representative of the diagnostic category were randomly selected for imaging and measurement from these cases. Additionally, 1,378 visually normal appearing intermediate cells from low and high grade squamous intraepithelial lesions, as well as from carcinoma cases, were identified for analysis. The nuclei were quantitatively characterized, and discriminant analyses were performed to derive a progression curve from normal cytology to carcinoma.
  
  
  RESULTS
  The lesion signatures show a clear increase in nuclear abnormality with increasing progression. A progression curve was derived based on mean discriminant function scores for each diagnostic category and on the mean nuclear abnormality values for the nuclei in each category, as expressed by their deviation in feature values from normal reference nuclei.
  
  
  CONCLUSIONS
  A numeric assessment of lesion progression for cervical precancerous and cancerous lesions based on karyometric measurements is possible and may provide an objective, precise characterization of each lesion as well as a basis for improved performance in automated cytology-based cervical cancer screening.
authors.affiliation: Division of Gynecology, Department of Obstetrics and Gynecology, University of Arizona, Tucson, Arizona 85721. fcisco@u.arizona.edu
authors.forename: Francisco A
authors.initials: FA
authors.lastname: Garcia
authors.forename: James
authors.initials: J
authors.lastname: Ranger-Moore
authors.forename: Bel
authors.initials: B
authors.lastname: Barker
authors.forename: John
authors.initials: J
authors.lastname: Davis
authors.forename: Molly
authors.initials: M
authors.lastname: Brewer
authors.forename: Jonathan
authors.initials: J
authors.lastname: Lozevski
authors.forename: Sajeet
authors.initials: S
authors.lastname: Vinyak
authors.forename: Yun
authors.initials: Y
authors.lastname: Liu
authors.forename: Jon
authors.initials: J
authors.lastname: Yemane
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Hatch
authors.forename: David S
authors.initials: DS
authors.lastname: Alberts
authors.forename: Hubert G
authors.initials: HG
authors.lastname: Bartels
authors.forename: Peter H
authors.initials: PH
authors.lastname: Bartels
mesh_terms: D002467:Cell Nucleus / Q000473:pathology; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D007620:Karyometry; D009361:Neoplasm Invasiveness; D011230:Precancerous Conditions / Q000175:diagnosis / Q000473:pathology; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology