IMAGE-ANALYSIS OF NUCLEAR CYTOPLASMIC RATIO IN CERVICAL SMEARS TO DISCRIMINATE 3 GRADES OF CERVICAL INTRAEPITHELIAL NEOPLASIA/

OBJECTIVE: To suggest which system of cytologic classification (Bethes da System or Would Health Organization [WHO]) of cervical lesions is m ore adequate for the Public Health Service of Sao Paulo State, Brazil, based on morphometric study with the Jandel Videoanalysis (JAVA) Syst em. STUDY DESIGN: The study comprised groups Of typical smears: cervic al intraepithelial neoplasia (CIN 1) separated into two subgroups: cyt opathic effects of human papillomavirus associated or not with dyskary osis, CIN 2 and CIN 3. The JAVA system of image analysis was used to d etermine the nuclear/cytoplasmic (N/C) ratio in abnormal cells from ea ch group. RESULTS: Significant differences were detected between the t hree grades of CIN and between the two subgroups of CIN 1. CONCLUSION: Although image analysis is not applicable to large-scale population s creening of cervical smears, its use in; the present study favored the three-grade cytologic classification (WHO). In addition, the three-gr ade classification offers the clinician more options for treatment. Co nsidering the clinical-laboratory characteristics of our public health service, the three-grade classification is more adequate.