Abstract
Despite the effectiveness of Pap-smear test in reducing the mortality rate due to cervical cancer, the criteria of the reporting standard of the Pap-smear test are mostly qualitative in nature. This study addresses the issue on how to define the criteria in a more quantitative and definite term. A negative Pap-smear test result, i.e. negative for intraepithelial lesion or malignancy (NILM), is qualitatively defined to have evenly distributed, finely granular chromatin in the nuclei of cervical squamous cells. To quantify this chromatin pattern, this study employed Fuzzy C-Means clustering as the segmentation technique, enabling different degrees of chromatin segmentation to be performed on sample images of non-neoplastic squamous cells. From the simulation results, a model representing the chromatin distribution of non-neoplastic cervical squamous cell is constructed with the following quantitative characteristics: at the best representative sensitivity level 4 based on statistical analysis and human experts’ feedbacks, a nucleus of non-neoplastic squamous cell has an average of 67 chromatins with a total area of 10.827μm 2; the average distance between the nearest chromatin pair is 0.508μm and the average eccentricity of the chromatin is 0.47.
Highlights
Papanicolaou-smear test is a useful screen test to detect precancerous stages of cervical cancer, enabling removal of intraepithelial lesions before progression into the invasive stage
Three measurements are computed for better understanding on the spread of the data, which are the distance between two nearest chromatin pair, the area of the chromatin and the eccentricity of the chromatin
To imitate the human diagnostic behavior, this study proposed different sensitivity levels for the segmentation of chromatin pattern to represent the potential view of individual pathologist
Summary
Papanicolaou-smear test is a useful screen test to detect precancerous stages of cervical cancer, enabling removal of intraepithelial lesions before progression into the invasive stage. Since the introduction of Pap-smear screening, mortality rate due to cervical cancer has been dramatically reduced [1,2]. Technical advancement in slide preparation has ameliorated from conventional preparation to liquid-based preparation, overcoming the limitations of cell loss and overlapping cell morphology to a single layer of cells, improving specimen adequacy and further enabling better sensitivity of the test [3,4]. In Pap-smear reporting, pathologists or cytotechnologists examine the cervical epithelial cells according to the worldwide recognised reporting standard, the Bethesda System for Reporting Cervical Cytology [5]. Changes in the morphology of the cell nucleus, which are termed as malignancy-.
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