Role of Micronuclesus in Cervical Intraepithelial Lesions and Carcinoma

  • Suganya Kuppovi Reddy JIPMER, Puducherry
  • Surendra Kumar Verma JIPMER, Pondicherry
  • Sajini Elizabeth Jacob JIPMER. Puducherry
  • Neelaiah Siddaraju JIPMER. Puducherry
  • Dasari Papa JIPMER, Puducherry
  • Suthanthira Kannan Government Medical College, Kozhikode
Keywords: Micronuclei, MN-score, cervical cancer, precancerous lesions


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

Author Biographies

Surendra Kumar Verma, JIPMER, Pondicherry
Professor, Department of Pathology
Sajini Elizabeth Jacob, JIPMER. Puducherry
Professor, Department of Pathology
Neelaiah Siddaraju, JIPMER. Puducherry
Professor and head, Department of Pathology
Dasari Papa, JIPMER, Puducherry
Professor & Head,Department of Obstetrics & Gynaecology
Suthanthira Kannan, Government Medical College, Kozhikode
Junior Resident, Department of Community Medicine,


1. Samanta S, Dey P, Nijhawan R. Micronucleus in cervical intraepithelial lesions and carcinoma. Acta Cytol. 2011;55(1):42–7.

2. Delfino V, Casartelli G, Garzoglio B, Scala M, Mereu P, Bonatti S, et al. Micronuclei and p53 accumulation in preneoplastic and malignant lesions of the head and neck. Mutagenesis. 2002;17(1):73–7.

3. Karaman A, Binici DN, Kabalar ME, Calikuşu Z. Micronucleus analysis in patients with colorectal adenocarcinoma and colorectal polyps. World J Gastroenterol WJG. 2008 ;14(44):6835–9.

4. Aires GMA, Meireles JRC, Oliveira PC, Oliveira JL, Araújo EL, Pires BC, et al. Micronuclei as biomarkers for evaluating the risk of malignant transformation in the uterine cervix. Genet Mol Res GMR. 2011;10(3):1558–64.

5. Arora SK, Dey P, Saikia UN. Micronucleus in atypical urothelial cells. Diagn Cytopathol. 2010;38(11):811–3.

6. Fenech M, Holland N, Chang WP, Zeiger E, Bonassi S. The HUman MicroNucleus Project--An international collaborative study on the use of the micronucleus technique for measuring DNA damage in humans. Mutat Res. 1999;428(1-2):271–83.

7. Solomon D. The Bethesda system for reporting cervical cytology: definitions, criteria, and explanatory notes. New York: Springer; 2004.pp?

8. Manos MM, Kinney WK, Hurley LB, Sherman ME, Shieh-Ngai J, Kurman RJ, et al. Identifying women with cervical neoplasia: using human papillomavirus DNA testing for equivocal Papanicolaou results. JAMA J Am Med Assoc. 1999;281(17):1605–10.

9. Solomon D, Davey D, Kurman R, Moriarty A, O’Connor D, Prey M, et al. The 2001 Bethesda System: terminology for reporting results of cervical cytology. JAMA J Am Med Assoc. 2002;287(16):2114–9.

10. Saxena U, Sauvaget C, Sankaranarayanan R. Evidence-based screening, early diagnosis and treatment strategy of cervical cancer for national policy in low- resource countries: example of India. Asian Pac J Cancer Prev APJCP. 2012;13(4):1699–703.

11. Leyden WA, Manos MM, Geiger AM, Weinmann S, Mouchawar J, Bischoff K, et al. Cervical cancer in women with comprehensive health care access: attributable factors in the screening process. J Natl Cancer Inst. 2005;97(9):675–83.

12. Fenech M, Kirsch-Volders M, Natarajan AT, Surralles J, Crott JW, Parry J, et al. Molecular mechanisms of micronucleus, nucleoplasmic bridge and nuclear bud formation in mammalian and human cells. Mutagenesis. 2011;26(1):125–32.

13. Guzmán P, Sotelo-Regil RC, Mohar A, Gonsebatt ME. Positive correlation between the frequency of micronucleated cells and dysplasia in Papanicolaou smears. Environ Mol Mutagen. 2003;41(5):339–43.

14. Leal-Garza CH, Cerda-Flores RM, Leal-Elizondo E, Cortés-Gutiérrez EI. Micronuclei in cervical smears and peripheral blood lymphocytes from women with and without cervical uterine cancer. Mutat Res. 2002;515(1-2):57–62.

15. Guzmán P, Sotelo-Regil RC, Mohar A, Gonsebatt ME. Positive correlation between the frequency of micronucleated cells and dysplasia in Papanicolaou smears. Environ Mol Mutagen. 2003;41(5):339–43.

16. Nersesyan AK. Possible role of the micronucleus assay in diagnostics and secondary prevention of cervix cancer: a minireview. T͡Sitologii͡a Genet. 2007;41(5):64–6.
Original Article

Most read articles by the same author(s)