Contribution of DNA ploidy image cytometry to the management of ASC cervical lesions

BACKGROUND. The Bethesda system classifies smears that Suggest an underlying cervical intraepithelial neoplasia (CIN) as ASC (atypical squamous cell) sinears. ASC sinears are Subdivided into ASCUS (of undetermined significance) and ASCH (cannot exclude a high-grade lesion). Today the management of ASCUS is a triage with HR-HPV testing and colposcopy is recommended for ASCH. The aim was to conduct a study on ASC smears to determine DNA ploidy measurement for the detection of CIN2+. METHODS. The link between a suspect DNA ploidy assessed by image cytometry and/or a positive HR-HPV testing was analyzed on 69 ASCUS and 82 ASCH sinears, and the presence of CIN2+ within 12 months after ASC diagnosis. The ploidy was suspect in case of aneuploidy, multipolidy, or in the presence( of cells with a DNA content >5c or >9c. RESULTS. Every woman who had a CIN2+ had a suspect DNA profile in the ASCUS smears and every woman except I was HR-HPV-positive. The link between a positive HR-HPV test or a suspect DNA profile or both and a CIN2+ was high (P = .019, .023, and .008, respectively). The presence of >9c cells was particularly, linked to CIN2+ (P = .0031). In all, 90.9% and 87.9% of the ASCH sinears with CIN2+ were, respectively, positive or had a suspect ploidy (P = .0000 and P = .0043), and the presence of >9c cells was also linked to CIN2+ (P = .003). CONCLUSIONS. HR-HPV testing and determination of the ploidy profile with special attention to 9c-exceeding Cells could be accurate for a better management of ASC sinears.