Quantitative pathology of the cervical intraepithelial neoplasia

The objective of this study was to determine the efficiency of quantitative microscopy as a method of estimating the progressive cervical intraepithelial neoplasia (CIN). The research design consisted of an analytical study of cases and controls. The study took place in the Pathology Services of 4 hospitals in our region and the Image Processing and Cytometry Service of the university. Two subsequent cervical biopsies taken more than six months apart belonging to 42 patients diagnosed for CIN were studied. As a reference, 20 normal biopsies were taken. Quantitative Microscopy by Digital Image Processing was applied to each one of the three epithelial layers. Cellular orientation, shape factor, perimeter, area and nuclear diameter were taken as maturative markers and the cellularity as a marker of proliferative change. The cellularity in the middle layer of the epithelium allowed us to distinguish patients with CIN (22.9 +/- 6.9) from normal cases (4.6 +/- 2.3) in 93% of the cases. According to this variable in the middle and superficial layers, in 95.2% of the cases 4 new groups were automatically defined. The shape factor of the cells in the superficial cell layer enabled us, although with low sensitivity (45.45%), to predict evolution towards cancer in 65.5% of the cases. In conclusion the validity of Quantitative Microscopy as an objective marker of structural change in the CIN was verified although its value as a predictive marker of evolution is low.