The predictive value of immature dysplastic cells in CIN I and II smears

This paper reports the predictive value of a subclassification of cervical intraepithelial neoplasm grade I and II smears. The follow-up period was a maximum of 1 yr. The subclassification was based on the presence of immature dysplastic cells ("IDC present") in the original smear. In 267 cases, these immature dysplastic cells were morphometrically defined. In an additional group of 14 cases, the immature dysplastic cells were exclusively in dense cell groupings which were unsuitable for morphometrical analysis; thus, only visual classification was possible. The predictive value negative (follow-up with negative findings or CIN I or II) of this method was 1.00. The predictive value positive (follow-up with CIN III) was 0.14. The sensitivity was 0.98 and the specificity 0.57. On the basis of this subclassification, cases that should be directly referred for further investigation can be selected. It is justifiable to follow-up the cases that are "IDC absent" with cytology alone. The described method is relatively simple, and can be performed in routine diagnostic laboratories. It is very valuable in settings where most of the initial smears and the follow-up are in the hands of general practitioners. Using the described method, patients who should be referred to the gynecologist for colposcopy and histology can be selected.