Assessing the role of nuclear morphometry in the screening of cervical pap smears

Abstract

Background: Globally, Cervical Cancer is recognized as the second most prevalent form of cancer in women. Cervical cancer is the second most prevalent cause of mortality among women in India, behind breast cancer. A Pap smear is a microscopic analysis of cervical cells that is used to identify malignant, pre-cancerous, or benign diseases of the cervix. Aim: Assessing the use of nuclear morphometry in the screening of cervical pap smears. Material and methods: We conducted a prospective examination of 90 cervical pap smears that were received in our department. There were 30 instances of Low grade squamous intraepithelial lesion (LSIL) in Group I, 30 cases of High grade squamous intraepithelial lesion (HSIL) in Group II, and 30 cases of Squamous cell carcinoma (SCC) in Group III. A digital picture of the field of 640 x 400 pixels was generated using a camera
attached to a microscope and a frame grabber card installed in a personal computer. Examined nuclear parameters: The radius is calculated by taking the average length of the radial line segments that extend from the center of the nuclear mass to each point on the nuclear boundary. The computer computed the average, standard deviation, and range for all the nuclear characteristics. The research only included LSIL, HSIL, and Squamous cell cancer. Patients with ASCUS, AGUS, and Pap smears without a verified histopathological diagnosis were not included in the research. Results: The nuclear morphometric parameters show significant differences among the three groups (LSIL, HSIL, and SCC). The mean radius for LSIL is 5.33 µm, for HSIL is 6.71 µm, and for SCC is 8.45 µm, with a pvalue of <0.001, indicating a significant increase in the radius from LSIL to SCC. Similarly, the nuclear area increases significantly from LSIL (28.67 µm²) to SCC (61.34 µm²). The perimeter and diameter also show a significant increase across the groups, with SCC having the highest values. All parameters (radius, nuclear area, perimeter, diameter, and compactness) show p-values <0.001 for comparisons between LSIL vs. HSIL, LSIL vs. SCC, and HSIL vs. SCC. The radius (r = 0.72), nuclear area (r = 0.74), perimeter (r = 0.69), diameter (r = 0.67), and compactness (r = 0.70) all have p-values <0.001, indicating a strong correlation between these nuclear features and the age of the patients. This suggests that as age increases, there are notable changes in nuclear morphometry, which could be indicative of disease progression. Conclusion: In conclusion, our study confirms the significant differences in nuclear morphometric parameters among LSIL, HSIL, and SCC, with SCC showing the most pronounced nuclear abnormalities. These findings align with previous research, highlighting the importance of nuclear morphometry in the screening and diagnosis of cervical lesions.