Abstract
Background: Micronuclei (MN) are considered sensitive indicators of chromosomal damage. Studies have emphasized the utility of MN-scoring in detection of increased risk of various cancers in humans. More recent studies have shown MN assay to be highly promising in cervical cancer screening. Aims: To evaluate the utility of micronuclei in distinguishing various squamous intraepithelial lesions and invasive squamous cell carcinoma of cervix. Methods: In this descriptive study, a total of 100 cases were studied, of which 50 were normal (control), 10 were high grade squamous intra epithelial lesions (HSIL) and 26 were invasive squamous cell carcinomas (SCC). Remaining 14 cases were equivocal entities comprising 3 ASCUS and 11 ASC-H cases. In each case, MN-count was done per 1000 epithelial cells and a consensus MN-score was taken after a consensus and careful review by 4 cytopathologists. Results: The mean MN-score showed a gradual increase from normal smear to invasive SCC cases. MN-score of HSIL and invasive SCC were significantly higher than the normal and ASC-H smears. Cases with premalignant/ malignant outcome had a significantly high MN-score as compared to cases with reactive outcome. Conclusion: MN-scoring is a simple, non invasive and cost effective test, which can be performed on an easily collected exfoliated cell sample. MN-assay in conjunction with conventional Pap test can be an effective tool for screening cervical cancer and identifying women at risk. DOI: 10.21276/APALM.1354
Highlights
Micronucleus (MN) originates from chromosome fragments or whole chromosomes that are not included in the main daughter nuclei during nuclear division.[1]
The mean MN-score showed a gradual increase from normal smear to invasive squamous cell carcinomas (SCC) cases
MN-assay in conjunction with conventional Pap test can be an effective tool for screening cervical cancer and identifying women at risk
Summary
Micronucleus (MN) originates from chromosome fragments or whole chromosomes that are not included in the main daughter nuclei during nuclear division.[1]. Cervical cancer is one of the most common cancers in India and Papanicolaou (Pap) cervical cytology is an effective screening method for its early detection. Bethesda 2001 system for reporting cervical cytology has certain equivocal entities like Atypical Squamous Cells of Undetermined Significance (ASCUS) and Atypical Squamous Cells cannot exclude HSIL (ASC-H).[7] Only a minor proportion of cases reported as ASCUS and ASC-H turn out to be cervical intraepithelial lesion (CIN) on histopathology.[8,9] HPV DNA testing is a useful adjunct in identifying those high risk cases, but it has cost limitations.[8] there is a need for a simple, reliable, reproducible & cost effective method for identifying the true CIN cases, among those reported as ASCUS and ASC-H. More recent studies have shown MN assay to be highly promising in cervical cancer screening
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