DIAGNOSTIC AND PROGNOSTIC RELEVANCE OF MALIGNANCY-ASSOCIATED CHANGES IN CERVICAL SMEARS

OBJECTIVE: For approximately 15 years, malignancy-associated changes ( MACs) have been consistently found by means of high-resolution cytomet ry in different tissues, especially in visually normal appearing cervi cal cells. Their biologic nature is not yet fully understood. The aim of this investigation was to assess the expression of MACs in cervical smears and to evaluate their prognostic relevance. STUDY DESIGN: This study was performed on normal intermediate cells obtained from 53 cyt ologically positive and 78 cytologically negative cervical smears. Fro m a second sample, 31 cases showing negative cytology were selected fo r a prospective longitudinal study. Densitometric and texture features were generated, and MACs were described on the basis of multivariate discriminant analysis.RESULTS: Discrimination between positive and neg ative cases was possible, with a correct classification rate of approx imately 80%. After a mean period of 29.5 months, we noted no statistic ally significant increase in the incidence of cervical intraepithelial neoplasia in the group of healthy but MAC-positive women as compared to those who were MAC negative. CONCLUSION: MACs were constantly expre ssed in the epithelium of the cervix. Although their prognostic releva nce remains unclear, MACs play an important role in the effort to auto mate cervical cytology.