Prediction of various grades of cervical neoplasia on plastic-embedded cytobrush samples. Discriminant analysis with...

The purpose of this study was to investigate whether discrimination into five groups of various grades of cervical preneoplasia and neoplasia is possible using discriminant analysis models. Data were analyzed for 242 cases diagnosed as either slight dysplasia (n = 50), moderate dysplasia (n = 50), severe dysplasia (n = 50), carcinoma in situ (n = 50) or invasive carcinoma (n = 42) and consisted of qualitative and quantitative features of cells derived from a repeat sample taken from the ectocervix as well as the endocervix using Cytobrushes. The samples were embedded in plastic, and thin sections were prepared, resulting in a monolayer of cut nuclei. The percentages of expected correct prediction were obtained by using 10,000 double cross-validation samples; the mean percentage of correct prediction into five groups using cross-validation was 65% (in the original analysis, 72%) and into two groups (dysplasia versus carcinoma in situ and invasive carcinoma) was 91% (93%). The results reflect group discrimination potential; we do not claim reliability of prediction for an individual patient. The patients were not a representative sample of the population; to investigate whether groups of patients could be discriminated on the basis of both qualitative and quantitative features, the data analyzed contain an almost equal number of observations in each of the five groups. The results indicate that features do not classify the cases in the same way; the discriminant analyses suggest that quantitative features play an important role in the discrimination of dysplasia from carcinoma cases, while the majority of the qualitative features are important in discrimination within the three dysplasia groups.