Fractal and Euclidean geometric diagnostic methodology of uterine cervix cells = Metodología diagnóstica geométrica fractal y euclidiana de células del cuello uterino

Background: Pathological interpretation of cellular form in cervical cytology is very important for preven- tion of cervical cancer. The methods most frequently used for assessment of this test have reproducibility and inter-observer variability problems. Objective: To make fractal and Euclidean measure- ments to mathematically diagnose normal and pre- malignant cells of cervical squamous epithelium. Methodology: 21 cells with normal, ASCUS or LSIL diagnosis according to the Bethesda system were assessed. Fractal and Euclidean geometric measures of three mathematical objects were calculated: cyto- plasm, nucleus and whole cell. Mathematical propor- tions between these measurements were calculated in order to compare them with conventional classification methods. Results: It was found that the nuclear border measures calculated with the 2-pixel grill and the surface measures could mathematically and objectively differentiate normal cells from the pre-malignant ones (ASCUS and LSIL). Conclusions: An objective and reproducible diagnos- tic method was developed; it allows to identify the evolution towards malignant cellular states based on simultaneous fractal and Euclidean measures, estab- lishing the severity level of ASCUS and LSIL cells.