Diagnosis of benign and malignant cervical specimens by multifiberoptic microspectrophometry and by flow cytometry

Two techniques for the automation of mass screening for cervical cancer were studied. Microspectrophotometry was tried first, using a novel multifiberoptic scanning system that measured the nuclear size and DNA content of cells in routine smears restained by the Feulgen technique. Specimen diagnoses were based on the percentages of cell types present, as determined by thresholds set for the two parameters. While this method gave good results in the automated detection of severe dysplasias and carcinomas, with only 3 of 72 cases misdiagnosed as negative (4.2%), it had a 22.9% false-positive rate (misdiagnosing 24 of 105 "benign" cases) and a 30.3% false-negative rate for adenocarcinomas (10 of 33 cases misclassified). The second approach involved flow cytometric measurements of specimens that were double stained for the assessment of both the DNA and RNA content, with the results analyzed by preset windows in a two-dimensional plane. This technique gave a 6.1% false-negative rate in 49 positive specimens and a 32.3% false-positive rate in 102 benign specimens, with an overall correct classification rate of 76.2%, including adenocarcinomas.