Does Micronucleus Score Significantly Correlate with Dysplasia in Cervical Pap Smears?

Abstract

Background: The grade of dysplasia on cervical pap smears may be indicated by micronucleus (MN) scoring, much like cancers of the oral cavity, urinary bladder, and esophagus. Methods: Cross-sectional study. MN scores of 106 subjects comprising all major diagnostic categories included in “The Bethesda system, 2014 for reporting cervical pap smears” were taken. High grade squamous intraepithelial lesion (HSIL) and Invasive carcinoma (IC) were further grouped as “high-risk” and the rest, “low-risk” to construct receiver operating characteristic (ROC) curve to seek a cutoff delineating the two classes. Analysis of variance was used to determine the significance of differences in MN scoring between the various groups. Results: The difference of mean MN scores of HSIL (9.4) and IC (10.7) was significant from the low-risk group but not within themselves. A huge difference in MN scores between low-grade squamous intraepithelial lesions and HSIL is notable. The difference of mean age was significant between high and low-risk groups. ROC curve delivered a cutoff of 5.15 to distinguish between the two categories with 85.7% sensitivity, 97.2% specificity, and 93.3% accuracy. Conclusions: Sequential and significant increase of MN score from low- to high-grade dysplasia is established by the current study. A cutoff of 5.15 MN scores adequately detects HSIL and IC. Despite its performance, MN scoring is time-consuming, labor-intensive, and strenuous process, which might make it difficult to impose on laboratories and pathologists.