A Dimensional Study on the Variation in Size of the Vaginal Squamous Cell Nucleus in Normal Menstrual Cycle

Abstract

In endocrine cytology which pursues change of female sex hormones, vaginal smear: by the Papanicolaou stain are employed to study chiefly the findings of squamous of the vagina on an integral basis. Of these findings the size of a nucleus constitute: a very important factor, which, however, seems to have been studied to subjectively, but scarcely taken up for a systematic, dimensional approach.
The establishment of standards for objective evaluat i on and dimensional determinatior has been recently emphasized, giving much credit to the importance of numerical data to be adopted as a parameter especially in autocytoscreening.
Regarding the autocytoscreening for cervic a l cancer, Dr. Yasuda, one of the author': colleagues, standardized nuclear diameter as 11μ to be used as a parameter. Here, it is desired to clarify whether his standardized value (11μ) is influenced by changed values of the squamous cell nucleus due to sex hormones. Indeed, few reports have beer made of a systematic, dimensional study of the size of the squamous cell nucleus due to change in sex hormones.
The present study was made with carefully selected nine mature women with a normal menstrual cycle, aged 28-38 years, at their mid follicular phase corresponding to the estrogen phase (the seventh day ± two days in menstruation), the ovulatory phase in the peak of the estrogen phase (the 14th day ± two days in menstruation), and the mid luteal phase corresponding to the progesterone phase following the estrogen phase (the 20th day ± two days in menstruation).
The vaginal smears at each phase were Papanicolaou stained; intermediate cell nuclei which apparently always appeared in vaginal smears and which were little affected by exogenous influence were statistically determined with an ocularmicrometer for their maximum, minimum, and average diameter maximum + minimum with the following results:
No. of nuclei max. diam. min. diam. average
Mid follicular phase 442 8.30 ± 1.30μ 7.15 ± 1.15μ 7.98 ± 1.19μ
Ovulatory phase 436 7.52 ± 1.39μ 6.62 ± 1.27μ 6.83 ± 1.25μ
Mid luteal phase 448 10.23 ± 1.27μ 9.26 ± 1.23μ 9.98 ± 1.16μ
A comparative study revealed that the data changed significantly at a 5 % leve l of significance. That is, nuclei were always shaped round or cylindric, but their size was slightly large at the mid follicular phase, becoming smallest at the ovulatory phase, and growing larger again to the largest at the mid luteal phase. However, even when enlarged they seldom exceeded the average 11μ. It was concluded that the establishment of over 11μi n diameter for the nucleus as an evaluating standard in the cytological diagnosis of cervical cancer seemed reasonable. It seems safe to state that any influence of sex hormones can be ignored so far as the nucleus diameter is concerned in determining malignant cells.