DNA measurements of cervical epithelial cells in combination with scanning electron microscopy

Ch, Wouters; Sc, Hesseling; Wt, Daems; Js, Ploem

doi:10.1007/bf00482984

Cited by 4 publications

(1 citation statement)

References 9 publications

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“…Precancerous lesions of the uterine cervix show cytogenetic aneuploidy28 as a marker of transition into aneuploid carcinomas 29–31. This aneuploidy has been demonstrated with cytometric methods as well 7–9, 12, 16, 17, 23–25, 27, 32–69. DNA aneuploidy has been regarded as an objective marker for progressive CIN 7, 33, 60.…”

Section: Discussionmentioning

confidence: 99%

DNA cytometry confirms the utility of the Bethesda system for the classification of Papanicolaou smears

Bollmann¹,

Bollmann²,

Henson

et al. 2001

Cancer

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BACKGROUND Developed in 1989, the Bethesda System has largely replaced previous classifications of Papanicolaou (Pap) smears from the uterine cervix. The system is binary, dividing smears into two groups — low‐grade, squamous, epithelial lesions (LSIL) or high‐grade, squamous, epithelial lesions (HSIL). A third category, atypical squamous cells of undetermined significance (ASCUS), is used to classify minimal cellular changes that do not satisfy the criteria for the low‐ or high‐grade categories. This study was designed to confirm the utility of this binary division and to compare the results with another classification system (the Munich II Nomenclature) that is not binary but contains three divisions or grades for dysplasia — low, intermediate, and high. METHODS Pap smears were obtained from 593 women with a cytologic diagnosis of dysplasia based on the Munich System. Smears were then classified by the Bethesda System into LSIL or HSIL. Patients were followed for 2 years either with biopsy or repeat cytology. The initial smears were restained by the Feulgen method, and ploidy was evaluated by interactive DNA cytometry. RESULTS Of 241 cases of LSIL, 39% were diploid, 57% polyploid, and 4% aneuploid. Of 352 cases classified HSIL, 4% were diploid, 17% polyploid, and 79% aneuploid. After 2 years of follow‐up, 2 of 108 patients who were biopsied and who were originally classified as diploid progressed to cervical intraepithelial neoplasia/carcinoma in situ (CIN/CIS) whereas 109 of 217 patients who were aneuploid and biopsied were found to have CINIII/CIS. CONCLUSIONS The two divisions of the Bethesda System, LSIL and HSIL, correlated with ploidy as evaluated by cytometry. Aneuploidy was found to be useful to separate cases of HSIL from those of LSIL as defined in the Bethesda System. Because of the binary division, use of a system with three divisions for dysplasia, such as the Munich II Nomenclature, creates a therapeutic dilemma because a single diagnostic category (usually the intermediate grade) may contain both self‐limiting and progressive lesions. DNA cytometry of Pap smears was found to be useful as a routine procedure. Cancer (Cancer Cytopathol) 2001;93:222–228. © 2001 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

DNA cytometry confirms the utility of the Bethesda system for the classification of Papanicolaou smears

Bollmann¹,

Bollmann²,

Henson

et al. 2001

Cancer

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Quantitative determination of acid-labile dna in cervical intraepithelial neoplasia

Partington

Sincock

Steele

1991

Cancer

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Using a modified Feulgen hydrolysis procedure and integrating microdensitometry, the acid-labile nuclear DNA in exfoliated cervical epithelial cells was quantified in a range of histologically confirmed cervical intraepithelial neoplasia (CIN), invasive cancer, and normal controls. The mean relative optical densities obtained for each sample group showed an increase from normal epithelium, through CIN grades, to invasive cancer. Although there was some overlap between groups, the difference in the overall mean values between the adjacent groups was statistically significant. The sensitivity of the test was 87.1% with a specificity of 99.2% and a predictive value of 99.5%, with no false negatives in the severe dysplasia and cancer groups. Quantitative data allows the threshold value to be altered to vary the sensitivity and specificity according to prevailing requirements. This suggests the possibility of using quantitative acid-labile DNA measurements to improve existing screening for cervical precancer. Cancer 67:3104-3109,1991. HE TRADITIONAL PAPANICOLAOU method of Cyto

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Image Analysis, Fluorescence and Laser Microscopy

Ploem¹

1991

Histochemical and Immunohistochemical Techniques

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DNA measurements of cervical epithelial cells in combination with scanning electron microscopy

Cited by 4 publications

References 9 publications

DNA cytometry confirms the utility of the Bethesda system for the classification of Papanicolaou smears

DNA cytometry confirms the utility of the Bethesda system for the classification of Papanicolaou smears

Quantitative determination of acid-labile dna in cervical intraepithelial neoplasia

Image Analysis, Fluorescence and Laser Microscopy

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