Predictive Value of Micronucleus Count in Cervical Intraepithelial Neoplasia and Carcinoma

Objective: A micronucleus is a small additional nucleus formed due to chromosomal loss or fragmentation. The aim of this study was to assess the utility of micronucleus count as a screening tool in cervical cancer. Material and Method: A total of 132 cases consisting of 42 pre-neoplastic and neoplastic cases and 90 non-neoplastic cases were studied. Only routine Papanicolaou-stained cervical smears were used. In each smear, the number of micronucleated cells and binucleated cells were counted under oil immersion and expressed as a count per 1,000 cells. The micronucleated and binucleated cell counts in pre-neoplastic, neoplastic and non-neoplastic categories were compared for statistical significance. The counts were also correlated with age, duration of marital life, number of pregnancies and abortions. Results: The micronucleus count and the binucleated cell count were significantly higher in the high - grade squamous intraepithelial lesion (HSIL) and invasive carcinoma categories compared to low - grade squamous intraepithelial lesion (LSIL) and non-neoplastic cases. Receiver operating characteristic (ROC) curve analysis revealed that micronucleus count and binucleated cell count possess a high degree of sensitivity and specificity for identifying HSIL and invasive carcinoma. Conclusion: Our results reveal that micronucleus evaluation in routine Pap smears is a very useful biomarker in cervical cancer screening. The binucleated cell count increases the predictive value of this simple test.