# Raman Spectroscopy of Individual Cervical Exfoliated Cells in Premalignant and Malignant Lesions
## 5 Conclusions  
Raman spectroscopy is a technique that could correctly classify cytology or cervical exfoliation samples of patients with premalignant/malignant lesions. The collection and analysis of the Raman spectra used to assess the cytoplasm and nucleus of single cervical cell preparations was performed. We found spectral differences in vibrational modes of carbohydrates, proteins, lipids, and nucleic acids. The differences in proteins (bands at 914, 942, 1243, 1440, 1648 cm\({}^{-1}\)) and in nucleic acids (bands at 992, 1077, 1323, 1574, 1600 cm\({}^{-1}\)) probably reflect the increased expression of oncogenes andoproteins in cancer cervical cells. On the discriminant analysis, cytoplasm spectra allow a classification efficiency of 76.5%. Our findings suggest that Raman spectroscopy of the nucleus of individual cervical cells may represent an objective screening method with a specificity of 79.3%, a sensitivity of 84.6%, and predictive power of 82.7% for identifying patients with cervical premalignant and malignant lesions. The application of this technique has the advantage that the destruction of the sample or complicated preparation processes are not necessary. Another advantage is that, since it is being carried out on cervical exfoliation samples, obtained routinely in cancer screening, it is possible to perform Pap and Raman measurements from a single sample. The measurements recorded in the cytoplasm and nucleus of individual cells allowed to define spectral differences corresponding to the components of cell biochemical processes in an objective, fast, and reproducible way. Further research is needed to encourage single-cell Raman spectroscopy application in the future as a support method to existing diagnostic approaches, reducing false-negative rates of current screening methods and avoiding delays in diagnosis and treatment of cervical cancer, thus improving prognosis. The following supporting information can be downloaded at: [[https://www.mdpi.com/article/10.3390/app12052419/s1](https://www.mdpi.com/article/10.3390/app12052419/s1)]([https://www.mdpi.com/article/10.3390/app12052419/s1](https://www.mdpi.com/article/10.3390/app12052419/s1)), Table S1: Raman Spectroscopy Studies on Cervical Cells for Cervical Cancer Diagnosis. References [41; 42; 43] are cited in the supplementary materials. Conceptualization, E.S.K.-M., A.G.R.V. and H.R.N.C. ; methodology, M.S.S.-L., E.S.K.-M. and H.R.N.C. ; software, C.A.I.H. ; validation, M.S.S.-L., C.A.I.H. and E.S.K.-M.; formal analysis, C.A.I.H. ; investigation, M.S.S.-L. and A.O.-D.; resources, E.S.K.-M., A.G.R.V. and H.R.N.C. ; data curation, M.S.S.-L. and C.A.I.H. ; writing--original draft preparation, M.S.S.-L.; writing--review and editing, A.O.-D. and E.S.K.-M.; visualization, A.O.-D.; supervision, E.S.K.-M., A.G.R.V. and H.R.N.C. ; project administration, E.S.K.-M., A.G.R.V. and H.R.N.C. ; funding acquisition, E.S.K.-M., A.G.R.V. and H.R.N.C. All authors have read and agreed to the published version of the manuscript. M.S.S.-L. and A.O.-D. acknowledge the financial support of CONACYT through a Ph.D. scholarship 479977. This document was edited for correct English language usage by qualified native English-speaking editors at AIP Author Services using UASLP funds. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The study was approved by the Institutional Review Board and the Research Ethics Committee of the Institute for Security and Social Services for the State Workers (ISSSTE) Clinic in San Luis Potosi (protocol code 006-18 CI).