Role of cervicitis in the Raman-based optical diagnosis of cervical intraepithelial neoplasia.

The Raman-based optical diagnosis of normal cervix, inflammative cervix (cervicitis), and cervical intraepithelial neoplasia was investigated on samples of 63 patients. The main alterations were found in the 857 cm(-1) (CCH deformation aromatic); 925 cm(-1) (C-C stretching); approximately 1247 cm(-1) (CN stretch, NH bending of Amide III); 1370 cm(-1) (CH2 bending); and 1525 cm(-1) (C=CC=N stretching) vibrational bands in accordance with previously reported in the literature comparing normal and malignant cervical tissue. The statistical analysis (principal components analysis, clustering, and logistic regression models) applied to the spectral data indicated that the full discrimination among normal and neoplastic tissues of cervix by Raman optical biopsy is seriously affected by the presence of inflammatory infiltrates, which increases the false-positive rate. This fact is specially relevant once cervicitis is a very common state (noncancerous) of the cervix of sexually active woman. The results suggest that, for the correct Raman-based diagnosis of normal cervix from cervical intraepithelial neoplasia, it is necessary to use an auxiliary way to discriminate the contribution from the inflammatory infiltrates.