The suitability of DNA cytometry for the prediction of the histological diagnosis in women with abnormal cervical smears

Abstract

Objective To analyse the suitability of DNA cytometry for predicting the histological diagnosis in Design Survey with the use of diagnostic information to revise disease probability.Setting Colposcopy clinic of a university hospital.Participants One hundred and ten women with two mildly or moderately dyskaryotic cervical smears and 98 women with one severely dyskaryotic smear.Interventions DNA cytometric analysis using cytocentrifuge preparations of single cell suspensions from a cervical scrape. The main DNA cytometric parameter was N5C (i.e. the absolute number of cells with a DNA content of more than 5C on a given surface with a predefined cell density).Main outcome measure The probability of finding CIN I1 or worse. On arbitrary grounds, a positive test should point to a probability of 85 % or higher.Results In the patients with cervical neoplasia, the value of N5C increased significantly with an increasing CIN grade (P < 0.001). In the patients with one severely dyskaryotic smear and in those with two mildly or moderately dyskaryotic smears, the prior probability of finding CIN I1 or worse was 94 % and 53 %, respectively. Therefore, DNA cytometric analysis might be particularly useful in women with mild or moderate dyskaryosis ; further analysis was restricted to this group. All of the women in whom the N5C value was higher than 52 were diagnosed as having CIN I1 or worse. Only 16 (14.5%) of the 110 women had an N5C value of 52 or higher. When the N5C value was 27, the probability of finding CIN I1 or worse was estimated to be 85%. Only 28 (25%) patients had an N5C value of 27 or higher.Conclusions DNA cytometry produced significant diagnostic information, as was shown by the relation between N5C and the histological diagnosis. However, the N5C value could not discriminate sufficiently between women with CIN I1 or worse and CIN I or better. Therefore, the management of individual patients with cytological abnormalities cannot be based on the results of DNA cytometric analysis.women with cervical dyskaryosis.

DNA‐Cytometry of Progressive and Regressive Cervical Intraepithelial Neoplasia

“…A recent study of the DNA-cytometric feature N5C (the absolute number of cells with DNA content of more than 5c) of patients with cervical neoplasia showed that the N5C values significantly increased with increasing severity of CIN grade. However, the N5C values could not discriminate between the two groups: (1) CIN II or more, and (2) CIN I or less [30]. These findings are in agreement with our previous results which showed that the 2.5c exceeding rate (ER) increased with increasing severity of the lesion [12].…”

The usefulness of cytodiagnosis and DNA cytometry on nasopharyngeal brush smears for the diagnosis of nasopharyngeal carcinoma

“…20,21 In addition, some investigators have suggested DNA cytometry is useful in equivocal cases, and here the goal is to differentiate between florid reactive inflammatory changes and true neoplasia. 22 A nondiploid state is known to correlate with the presence of carcinoma.…”

Prospective clinical study comparing DNA flow cytometry and HPV typing as predictive tests for persistence and progression of CIN I/II

“…High-resolution DNA-flow cytometry is known to be able to detect stem-cell lines with mutated DNA (21). Using DNA flow cytometry (22) and DNA image cytometry (23), a significant correlation between aneuploidy and grade of CIN has been shown. Even morphologically normal squamous epithelium adjacent to high-grade cervical intraepithelial neoplasia does not seem to contain any aneuploid cells (24).…”