Document Type : Original Article(s)

Authors

Department of Pathology, SHKM, GMC Nalhar, Nuh, Haryana, India

Abstract

Background: Malignant lesions of the cervix are the most frequent cause of mortality and morbidity and the third most common cause of cancer deaths in women worldwide. The incidence of cervical cancer is progressively reducing due to the routine use of Papanicolaou (Pap) smears to detect precancerous and early malignant lesions. Moreover, since it is based on subjective morphological assessment, false positive or negative reports are likely to be there. Using morphometric techniques, there have been attempts to use objective parameters to improve the accuracy of reports. In the present study, we used Image Morphometric Software and some of its plugins in order to create macro-images to analyze a large number of cells at a given time and study various nuclear parameters, useful in evaluating pre-malignant and malignant cervical Pap smears.
Method: A retrospective study was done on abnormal Pap smears. Bethesda System was used for the categorization of cervical Pap smears into premalignant and malignant lesions. Nuclear parameters were calculated employing Image-Pro 2.0 Morphometric Software. The analyzed parameters included nuclear area, perimeter, radius, and compactness. The obtained results were statistically analyzed using SPSS software version 19.0.
Results: Nuclear area, perimeter, radius, and compactness were found to be statistically significant parameters in differentiating premalignant from malignant cervical smears (P < 0.05).
Conclusion: Nuclear morphometry was found to be a useful objective way and an adjunct to conventional microscopy in differentiating premalignant from malignant cervical lesions.

Keywords

How to cite this article:

Hasija S, Kalhan S, Garg S, Sharma P, Singh P, Sethi B. Role of morphometry as diagnostic adjunct in evaluating premalignant and malignant cervical cytology. Middle East J Cancer. 2022;13(1):67-73. doi: 10.30476/mejc.2021.85637.1301.

1. Momenimovahed Z, Salehiniya H. Cervical cancer in Iran: integrative insights of epidemiological analysis. Biomedicine (Taipei). 2018;8(3):18. doi:10.1051/ bmdcn/2018080318.
2. Safaeian M, Solomon D, Castle PE. Cervical cancer prevention--cervical screening: science in evolution. Obstet Gynecol Clin North Am. 2007;34(4):739-ix. doi:10.1016/j.ogc.2007.09.004.
3. Wesoła M, Lipiński A, Jeleń M. Morphometry in the cytological diagnosis of cervical smears. Adv Clin Exp Med. 2014;23(2):289-93. doi:10.17219/ acem/37080.
4. Huang PC, Chan YK, Chan PC, Chen YF, Chen RC, Huang YR. Quantitative assessment of pap smear cells by PC-based cytopathologic image analysis system and support vector machine. In: Zhang D., editor. Medical biometrics. ICMB 2008. Lecture Notes in Computer Science, vol 4901. Springer, Berlin, Heidelberg. doi:10.1007/978-3-540-77413-6_25.
5. Wolberg WH, Street WN, Mangasarian OL. Importance of nuclear morphology in breast cancer prognosis. Clin Cancer Res. 1999;5:3542-50.
6. Bukhari M, Saba K, Qamar S, Majeed M, Niazi S, Naeem S. Clinicopathological importance of Papanicolaou smears for the diagnosis of premalignant and malignant lesions of the cervix. J Cytol. 2012;29(1):20–5. doi: 10.4103/0970-9371.93213.
7. Nayar R, Wilbur DC. The Bethesda system for reporting cervical cytology: A historical perspective. Acta Cytol. 2017;61(4-5):359-72. doi: 10.1159/ 000477556.
8. Lorenzo-Ginori JV. Digital image processing in cell imaging: A review on research developments. Conference UCLV- VLIR 2014. Available at : https://www.researchgate.net/publication/277246844_Digital_Image_Processing_in_Cell_Imaging_A_Review_on_Research_Developments
9. Divya Rani MN, Narasimha A, Harendra Kumar ML, Sheela SR. Evaluation of pre-malignant and malignant lesions in cervico vaginal (PAP) smears by nuclear morphometry. J Clin Diagnostic Res. 2014;8(11):16-9. doi: 10.7860/JCDR/2014/10367.5221.
10. Sanyal P, Ganguli P, Barui S, Deb P. Pilot study of an open-source image analysis software for automated screening of conventional cervical smears. J Cytol. 2018;35:71-4.
11. Sindhu C, Shariff S. Role of nuclear morphometry in cervicovaginal Papanicolaou smears and its utility in diagnosing cervical lesions. Int J Clin Diagn Pathol. 2020;3(1):227–34.
12. Tiwari AK, Khare A, Grover SC, Bansal R, Sharma S. Role of nuclear morphometry in screening of cervical pap smear. J Clin Diag Res (JCDR). 2019; 13(5):13-6.
13. Deka L, Gupta S. Nuclear morphometry and texture analysis on cytological smears of thyroid neoplasms?: a study of 50 cases. Malays J Pathol. 2017;39(1):33-7.
14. Kalhan S, Dubey S, Sharma S, Dudani S, Preeti, Dixit M. Significance of nuclear morphometry in cytological aspirates of breast masses. J Cytol. 2010;27(1):16-21.doi: 10.4103/0970-9371.66694.