CytoJournal · Nov 5, 2026
Automated image-based deoxyribonucleic acid ploidy analysis for detecting high-grade squamous intraepithelial lesions in a hospital-based cervical cancer screening program in Taiyuan, Northern China
By Wang Y, Qi C
Objectives: The objective of the study is to evaluate the diagnostic performance of deoxyribonucleic acid (DNA) ploidy analysis for detecting cervical intraepithelial neoplasia grade 2 or worse (CIN2+) and to compare it with high-risk human papillomavirus (hrHPV) testing and cytology in a cervical cancer (CC) screening cohort. Material and Methods: This study analyzed 1,640 women undergoing cervical screening. All participants underwent hrHPV testing, cytology, and DNA ploidy analysis. Agreement between methods was assessed using weighted kappa statistics. Odds ratios (ORs) for CIN2+ were calculated. Diagnostic performance was evaluated by the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Results: The agreement between DNA ploidy and cytology was substantial (weighted kappa = 0.754). DNA ploidy and cytology demonstrated comparable AUCs for detecting CIN2+ (0.690 and 0.700), which were significantly higher than that of hrHPV testing (0.570, all P <0.05). The sensitivity and NPV of the three tests were comparable. However, the specificity of both DNA ploidy (63.0%) and cytology (61.5%) was significantly higher than that of hrHPV (31.9%, all P <0.001). The risk of CIN2+ increased significantly with more severe DNA ploidy abnormalities (POSITIVE vs. NEGATIVE: OR = 6.26, P <0.001). The diagnostic performance of three combined strategies using hrHPV with DNA ploidy was comparable to that of three parallel strategies using hrHPV with cytology (all P >0.05). Conclusion: DNA ploidy analysis shows diagnostic performance for CIN2+ that is comparable to cytology and superior to hrHPV testing in specificity. DNA ploidy shows potential as an objective adjunct or alternative in opportunistic cervical screening settings.