Abstract

The successful management of cervical intraepithelial neoplasia (CIN) with proper screening and treatment methods could prevent cervical cancer progression. We propose a bioimpedance spectroscopic measurement device and a multi-electrode probe as an independent screening tool for CIN. To evaluate the performance of this screening method, we enrolled 123 patients, including 69 patients with suspected CIN and 54 control patients without cervical dysplasia who underwent a hysterectomy for benign disease (non-CIN). Following conization, the electrical properties of the excised cervical tissue were characterized using an electrical bioimpedance spectroscopy-based multi-electrode probe. Twenty-eight multifrequency voltages were collected through the two concentric array electrodes via a sensitivity-optimized measurement protocol based on an electrical energy concentration method. The electrical properties of the CIN and non-CIN groups were compared with the results of the pathology reports. Reconstructed resistivity tended to decrease in the CIN and non-CIN groups as frequency increased. Reconstructed resistivity from 625 Hz to 50 kHz differed significantly between the CIN and non-CIN groups (p < 0.001). Using 100 kHz as the reference, the difference between the CIN and non-CIN groups was significant. Based on the difference in reconstructed resistivity between 100 kHz and the other frequencies, this method had a sensitivity of 94.3%, a specificity of 84%, and an accuracy of 90% in CIN screening. The feasibility of noninvasive CIN screening was confirmed through the difference in the frequency spectra evaluated in the excised tissue using the electrical bioimpedance spectroscopy-based multi-electrode screening probe.

Highlights

  • Cervical intraepithelial neoplasia (CIN), called cervical dysplasia, is a precancerous lesion of cervical cancer in which epithelial cells of the cervix become dysplastic.These local lesions, limited to the cervical epithelium, can progress to cervical cancer due to various factors, including human papillomavirus (HPV) infection [1]

  • We propose electrical bioimpedance spectroscopy with a multi-electrode probe as an independent noninvasive CIN screening method for covering the region, including the squamous-columnar junction of the cervical tissue

  • The reconstructed resistivity tended to decrease as the frequency increased, with comparisons between frequencies being significantly greater for samples from patients without than with CIN (Figure 4a,b)

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Summary

Introduction

Cervical intraepithelial neoplasia (CIN), called cervical dysplasia, is a precancerous lesion of cervical cancer in which epithelial cells of the cervix become dysplastic. These local lesions, limited to the cervical epithelium, can progress to cervical cancer due to various factors, including human papillomavirus (HPV) infection [1]. Low-grade squamous intraepithelial lesions (LSILs, known as CIN I) are recognized as a histological diagnosis of benign viral replication that should be managed conservatively, whereas CIN III is recognized as a true pre-invasive precursor with the potential to progress to cancer [2]. Diagnosis and treatment at the stage of CIN may prevent the development of cervical cancer

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