Retrospective DNA Analyses in Cervical Dysplasia as Related to Neoplastic Progression or Regression

Nasiell, K; Auer, Gert; Nasiell, M; Zetterberg, Anders

doi:10.1097/00006254-198002000-00023

Cited by 6 publications

(9 citation statements)

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“…Thus, the 82 women in group B presented with PAP smears negative for HPV (6 patients), changes consistent with inflammatory atypia only (74 patients), and changes consistent with HPV-CIN (2 patients). Thus, our present data on the effects of punch biopsy on the clinical course of HPV lesions are not comparable with those presented in the previous studies for CIN (Koss et al 1963;Nasiell et al 1979Nasiell et al , 1983Richart 1969;Stern & Neely 1964).…”

Section: Discussioncontrasting

confidence: 98%

Natural history of cervical human papillomavirus (HPV) infections based on prospective follow‐up

Syrjänen¹,

Väyrynen²,

Saakikoski³

et al. 1985

BJOG

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Summary. To assess the natural history of human papillomavirus (HPV) lesions in the uterine cervix, a prospective follow‐up of untreated lesions has been conducted since late 1981. The present report summarizes the data on 343 women with cervical HPV lesions currently followed‐up for a mean of 18.7 (SD 15.2) months by colposcopy and PAP smears (group R) or by additional punch biopsy (group A). Initially these tw7o groups were classified on the first PAP smears, presenting with HPV‐induced cytopathic changes, and either with (group A) or without (group B) concomitant changes suggestive of cervical intraepithelial neoplasia (CIN). The clinical course of the HPV lesions could not be predicted adequately from the findings of the first PAP smears, as evidenced by the higher progression rate (154%) in the 214 women initially classified in group B, compared with 116% in the 129 women classified in group A. Furthermore, the number progressing to careinomia in situ requiring conization was equal (seven patients) in the two groups. This necessitated a more flexible approach to follow‐up, permitting transfer of patients between groups, which resulted in a final allocation of 261 women to group A, and 82 to group B. To date, 25% of the total of 343 HPV lesions have regressed. 61% have persisted, and 14% have progressed. Of the latter, a total of 14 (4.1%) have been coned due to progression to carcinoma in situ. The rate of regression seems to be inversely related, and progression directly related. to the degree of HPV‐associated CIN. The results are discussed in the light of the well‐established natural history of classical CIN. Generally recognized as premalignant tesions. The present results, demonstrating that the natural history of cervical HPV lesions is very similar to that o f CIN, further substantiate the concept of HPV lesions as precursors of cervical cancer. With the potential to progress to carcinoma in situ when left untreated.

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Section: Discussioncontrasting

confidence: 98%

Natural history of cervical human papillomavirus (HPV) infections based on prospective follow‐up

Syrjänen¹,

Väyrynen²,

Saakikoski³

et al. 1985

BJOG

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“…This is consistent with previous observations in human cervical lesions (12). On the other hand, previous data (1,8,10,12) and the data reported herein strongly support the suggestion that invasive carcinoma regularly is preceeded by an increase of the cellular DNA level above the normal 4c region which generally occurs early in the carcinogenic process. We believe that the use of a combined cytomorphological and cytochemical diagnostic procedure as suggested in Figure 5 makes it possible to detect atypical cells and at the same time to distinguish them from the majority of nonspecific cellular changes.…”

Section: Discussionsupporting

confidence: 90%

“…Cytomorphology: The cytological criteria used are based on a grading system for squamous bronchial epithelium in Papanicolaoustained smear preparations developed at the Sabbatsberg Hospital, Stockholm, Sweden (1,10,(12)(13)(14). Squamous metaplastic and neoplastic bronchial cells were graded into regular squamous metaplastic cells, squamous metaplastic cells with mild, moderate and severe atypia, and cancer cells.…”

Section: Methodsmentioning

confidence: 99%

The significance of DNA measurements for the early detection of bronchial cell atypia

Ono

Auer

1983

Cytometry

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Investigations in an experimental model system and in clinical material indicate that squamous bronchial carcinoma is regularly preceded by the occurrence of bronchial cells with DNA values exceeding significantly the normal 4c region. The studies also show that cytomorphological methods do not allow the discrimination between milder forms of atypia and nonspecific cellular alterations. W e describe a combined cytomorphological and cytochemical diagnostic procedure which facilitates the distinction between atypical squamous cells and nonspecific cellular changes in the bronchial tree.

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“…Studies exploring the development of fully automated machine vision systems in pathological diagnosis are relatively uncommon. Advances have mainly been in the field of cytology, where work has focused on the analysis of cervical cytological smears20–29. Machines have now been developed which can automatically scan cervical smears, digitally analyse the identified cells, and detect quantitative nuclear abnormalities indicative of malignancy and premalignant change.…”

Section: Discussionmentioning

confidence: 99%

An automated machine vision system for the histological grading of cervical intraepithelial neoplasia (CIN)

et al. 2000

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The histological grading of cervical intraepithelial neoplasia (CIN) remains subjective, resulting in inter- and intra-observer variation and poor reproducibility in the grading of cervical lesions. This study has attempted to develop an objective grading system using automated machine vision. The architectural features of cervical squamous epithelium are quantitatively analysed using a combination of computerized digital image processing and Delaunay triangulation analysis; 230 images digitally captured from cases previously classified by a gynaecological pathologist included normal cervical squamous epithelium (n=30), koilocytosis (n=46), CIN 1 (n=52), CIN 2 (n=56), and CIN 3 (n=46). Intra- and inter-observer variation had kappa values of 0.502 and 0.415, respectively. A machine vision system was developed in KS400 macro programming language to segment and mark the centres of all nuclei within the epithelium. By object-oriented analysis of image components, the positional information of nuclei was used to construct a Delaunay triangulation mesh. Each mesh was analysed to compute triangle dimensions including the mean triangle area, the mean triangle edge length, and the number of triangles per unit area, giving an individual quantitative profile of measurements for each case. Discriminant analysis of the geometric data revealed the significant discriminatory variables from which a classification score was derived. The scoring system distinguished between normal and CIN 3 in 98.7% of cases and between koilocytosis and CIN 1 in 76.5% of cases, but only 62.3% of the CIN cases were classified into the correct group, with the CIN 2 group showing the highest rate of misclassification. Graphical plots of triangulation data demonstrated the continuum of morphological change from normal squamous epithelium to the highest grade of CIN, with overlapping of the groups originally defined by the pathologists. This study shows that automated location of nuclei in cervical biopsies using computerized image analysis is possible. Analysis of positional information enables quantitative evaluation of architectural features in CIN using Delaunay triangulation meshes, which is effective in the objective classification of CIN. This demonstrates the future potential of automated machine vision systems in diagnostic histopathology.

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Retrospective DNA Analyses in Cervical Dysplasia as Related to Neoplastic Progression or Regression

Cited by 6 publications

References 0 publications

Natural history of cervical human papillomavirus (HPV) infections based on prospective follow‐up

Natural history of cervical human papillomavirus (HPV) infections based on prospective follow‐up

The significance of DNA measurements for the early detection of bronchial cell atypia

An automated machine vision system for the histological grading of cervical intraepithelial neoplasia (CIN)

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