COMPARISON OF FOURIER-TRANSFORM INFRARED SPECTROSCOPIC SCREENING OF EXFOLIATED CERVICAL CELLS WITH STANDARD PAPANICOLAOU SCREENING

To compare Fourier-transform infrared (FTIR) spectroscopy in screening cervical cytology and standard Papanicolaou (Pap) screening with colp oscopic directed biopsy as a ''gold standard,'' we prospectively gathe red FTIR samples and Pap smears of all patients attending our program' s colposcopy clinics, from February to October 1995. We recorded demog raphic data for each patient including colposcopy, cytology, treatment follow-up, and histology. Using the colposcopically directed biopsy a s the gold standard, exfoliated cervical cells from 301 patients were collected to compare cytology and FTIR spectroscopy. Based on previous ly established criteria, we provided distinctive definitions of both n egative/positive FTIR, cytology, and histology. Results of 301 cases s howed 196 positive and 105 negative cytologies. The sensitivity, speci ficity, false-negative rate, and false-positive rate for the Pap test were 86.6, 90.5, 13.4, and 9.5%, respectively. However, FTIR results v ersus histology showed 215 positive and 86 negative with a sensitivity of 98.6% and specificity of 98.8%. False-negative and false-positive rates were 1.4 and 1.2%, respectively, In the 12 cervical cancers ther e were no false-negative FTIR results but 3 false-negative Pap smears. The positive and negative predictive values for FTIR were 99.5 and 96 .5% while the Pap values were 95.9 and 72.3%. Compared to standard Pap smears, FTIR has a better false-negative rate and negative predictive value in this preliminary study. Further work, to establish the range of each of the spectral criteria for different grades of dysplasia an d that among various infectious effects, needs to be conducted before applying this research tool to a population-based study. (C) 1997 Acad emic Press.