Video-enhanced optical microscopy objectively confirms that immunocytochemical biomarker supplementation of routine cytology permits separation of (1) "pre"-cancer epithelial cells from JHLP screened individuals who subsequently developed lung cancer from (2) similarly atypical epithelial cells from JHLP participants who did not. The establishment of a bank of sputum cytology specimens along with a data respository of 5-yr follow-up and clinical outcome had permitted banked specimens to be immunostained and scored against a gold standard of subsequent histologic lung cancer. A highly skilled cytopathologist, interpreting immunostained screening sputum specimens and blinded to the clinical outcome, originally was able to correctly predict clinical outcome with 88.7% accuracy compared to this "gold standard" (Tockman et al., J Clin Oncol 1988;6:1685-1693). This study presents an independent confirmation of that earlier immunocytochemical classification through feature extraction of digitally recorded, transmission optical microscope video images of immunostained, moderately atypical sputum cells from the original slides.