Pap smears are considered as the primary diagnostic modality in detecting the pre-malignant lesions and Carcinoma cervix. Cellular changes due to infections, drugs, hormonal fluctuations mimic pre-malignant conditions which results in false negative results. Hence nuclear features are very important for diagnosing dysplastic cells. The nuclear parameters like Area, Perimeter, Maximum diameter, Radius and Nuclear compactness are important to determine dysplastic cell by morphometric analysis which increase the sensitivity of the results of Pap smears.
Objectives: (1) To study the conventional Pap smears findings of biopsy proven cases of Low grade Squamous Intraepithelial Lesion (LSIL), High grade Squamous Intraepithelial Lesion (HSIL) and Squamous Cell Carcinoma (SCC).
(2) to study the nuclear morphometric parameters using Image J software and correlate the findings of Pap smear cytology with the nuclear morphometric parameters.
Methodology: 125 cases were selected retrospectively which were screened by Routine pap smears and diagnosed as LSIL (25 cases), HSIL (25 cases), Squamous cell carcinoma (25 cases) and Normal Pap smears (50 cases) were included as control. Representative areas of the smear were selected and digital images were produced by a camera on the microscope using 40x objective and the images were analyzed through Image J Software developed by National Institute of Health, USA. Around 50 nuclei/smear were analyzed and measurements of nuclear parameters like Nuclear Area, Perimeter, Maximum diameter, Radius and Compactness (perimeter2/area) were made on the cell images in a precise manner.
Results: The size of neoplastic nuclei were larger than normal nuclei. More than the enlargement, anisonucleosis was found to be a better indicator of neoplasia.
Conclusion: Nuclear morphometry can be used as a diagnostic tool in differentiating between the premalignant and malignant lesions of cervix.