DNA-CYTOMETRY OF PROGRESSIVE AND REGRESSIVE CERVICAL INTRAEPITHELIAL NEOPLASIA

A retrospective analysis was performed on archival cervical smears fro m a group of 56 women with cervical intraepithelial neoplasia (CIN), w ho had received follow-up by cytology only. Automated image cytometry of Feulgen stained DNA was used to determine the differences between p rogressive and regressive lesions. The first group of 30 smears was fr om women who had developed cancer after initial smears with dysplastic changes (progressive group). The second group of 26 smears with dyspl astic changes had shown regression to normal (regressive group). The g oal of the study was to determine if differences in cytometric feature s existed between the progressive and regressive groups. CIN categorie s I, II and III were represented in both groups, and measurements were pooled across diagnostic categories. Images of up to 700 intermediate cells were obtained from each slide, and cells were scanned exhaustiv ely for the detection of diagnostic cells. Discriminant function analy sis was performed for both intermediate and diagnostic cells. The most significant differences between the groups were found for diagnostic cells, with a cell classification accuracy of 82%. Intermediate cells could be classified with 60% accuracy. Cytometric features which affor ded the best discrimination were characteristic of the chromatin organ ization in diagnostic cells (nuclear texture). Slide classification wa s performed by thresholding the number of cells which exhibited progre ssion associated changes (PAC) in chromatin configuration, with an acc uracy of 93 and 73% for diagnostic and intermediate cells, respectivel y. These results indicate that regardless of the extent of nuclear aty pia as reflected in the CIN category, features of chromatin organizati on can potentially be used to predict the malignant or progressive pot ential of CIN lesions.