Identification of progressive cervical epithelial cell abnormalities using DNA image cytometry.
BACKGROUND
The objectives of the current study were to compare the capabilities of conventional cervical cytology and of DNA image cytometry (DNA-ICM) in the prediction of progressive or regressive behavior in atypical squamous cells (ASC), low-grade squamous intraepithelial lesions (LSIL), and atypical glandular cells (AGC).


METHODS
One hundred ninety-six women with Papanicolaou (Pap) smears that yielded diagnoses of ASC, LSIL, or AGC were included in a prospective cohort study. Slides were classified according to the Bethesda system. DNA-ICM was performed according to the consensus reports of the European Society of Analytical Cellular Pathology.


RESULTS
Reference standard verification was available in 108 patients. The rate of DNA aneuploidy in Pap smears increased significantly from cervical intraepithelial neoplasia 1 (CIN1) (54%) and CIN2 (64.3%) to CIN3 or greater (CIN3+) (83.3%) in subsequent biopsies (P < 0.05). Using ASC, LSIL, and AGC as input cytologic diagnoses and >/= CIN2 as the output histologic diagnosis, the positive predictive values (PPVs) for conventional cytology and DNA-ICM were 35.2% and 65.9%, respectively (P < 0.001). The negative predictive value (NPV) of DNA-ICM was 85.0%. When >/= CIN3 was used as the output histologic diagnosis, conventional cytology had a PPV of 22.2%. The PPV and NPV of DNA-ICM were 43.9% and 93.3%, respectively.


CONCLUSIONS
The results of the current study confirmed the prognostic validity of DNA image cytometry for differentiation between progressive and regressive lesions in patients with ASC, LSIL, and AGC diagnoses.
Grote
Hans Juergen
HJ
Institute of Cytopathology, Heinrich-Heine University of Düsseldorf, Düsseldorf, Germany.
Nguyen
Huy V Q
HV
Leick
Anand Gilbert
AG
Böcking
Alfred
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000235:genetics*; D002584:Cervix Uteri / Q000166:cytology; D015331:Cohort Studies; D004273:DNA, Neoplasm / Q000032:analysis*; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D006801:Humans; D019044:Image Cytometry; D008875:Middle Aged; D065006:Papanicolaou Test; D011237:Predictive Value of Tests; D011379:Prognosis; D012984:Software; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000235:genetics*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000235:genetics*
D004273:DNA, Neoplasm