Predictive value of phenotypic cytologic characteristics in early dysplastic cervical lesions

Four phenotypic cytologic parameters (koilocytotic changes, binucleation, multinucleation and the presence of metaplastic dysplastic cells) were evaluated in the initial cervical smears from 89 women who presented with slight or moderate dysplastic changes and had an adequate follow-up. The cases were divided in two groups according to their evolution: the 51 cases constituting group I showed persistence or progression of the lesions while the 38 cases in group II showed regression. Koilocytosis in 40% or more of the cells in a smear proved to have the greatest predictive value as an indicator of a lesion with less risk of progression. Multinucleation may have a similar value, but to a lesser degree. Binucleation and metaplastic dysplastic cells showed no statistical differences between persistence cases and regression cases. A fifth parameter, positivity to human papillomavirus capsid antigen by the immunoperoxidase technique, doubled its frequency in the regression group. The evaluation of these variables may provide a means of assessing the evolutionary potential of precursor cervical lesions, based on these lesions' cytologic phenotypic profiles.