Association between micronucleus frequency and cervical intraepithelial neoplasia grade in Thinprep cytological test and its significance

• Published in: International journal of clinical and experimental pathology 2015-01, Vol.8 (7), p.8426-8432
• Main Authors: Shi, Yong-Hua, Wang, Bo-Wei, Tuokan, Talaf, Li, Qiao-Zhi, Zhang, Ya-Jing
• Format: Article
• Language: English
• Subjects: Adult; Aged; Area Under Curve; Cervical Intraepithelial Neoplasia - diagnosis; Cervical Intraepithelial Neoplasia - genetics; Cervical Intraepithelial Neoplasia - pathology; Cervical Intraepithelial Neoplasia - virology; DNA, Viral - genetics; Female; Human Papillomavirus DNA Tests; Humans; Micronuclei, Chromosome-Defective; Micronucleus Tests; Middle Aged; Neoplasm Grading; Original; Papanicolaou Test; Papillomaviridae - genetics; Predictive Value of Tests; ROC Curve; Squamous Intraepithelial Lesions of the Cervix - diagnosis; Squamous Intraepithelial Lesions of the Cervix - genetics; Squamous Intraepithelial Lesions of the Cervix - pathology; Squamous Intraepithelial Lesions of the Cervix - virology; Uterine Cervical Neoplasms - diagnosis; Uterine Cervical Neoplasms - genetics; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - virology; Vaginal Smears; Young Adult
• ISSN: 1936-2625

A micronucleus is an additional small nucleus formed due to chromosomes or chromosomal fragments fail to be incorporated into the nucleus during cell division. In this study, we assessed the utility of micronucleus counting as a screening tool in cervical precancerous lesions in Thinprep cytological test smears under oil immersion. High risk HPV was also detected by hybrid capture-2 in Thinprep cytological test smears. Our results showed that micronucleus counting was significantly higher in high-grade squamous intraepithelial lesion (HSIL) and invasive carcinoma cases compared to low-grade squamous intraepithelial lesion (LSIL) and non-neoplastic cases. Receiver operating characteristic (ROC) curve analysis revealed that micronucleus counting possessed a high degree of sensitivity and specificity for identifying HSIL and invasive carcinoma. Cut-off of 7.5 for MN counting gave a sensitivity of 89.6% and a specificity of 66.7% (P = 0.024 and AUC = 0.892) for detecting HSIL and invasive carcinoma lesions. Multiple linear regression analysis showed that only HSIL and invasive cancer lesions not age, duration of marital life and number of pregnancy are significantly associated with MN counting. The positive rate of high risk HPV was distinctly higher in LSIL, HSIL and invasive cancer than that in non-neoplstic categories. In conclusions, MN evaluation may be viewed as an effective biomarker for cervical cancer screening. The combination of MN count with HPV DNA detection and TCT may serve as an effective means to screen precancerous cervical lesions in most developing nations.