Reporting of "LSIL with ASC-H" on cervicovaginal smears: is it a valid category to predict cases with HSIL follow-up?
Recently it has been shown that there is a 15-30% risk of associated cervical intraepithelial neoplasia (CIN 2-3 or greater) for a low-grade squamous intraepithelial lesion (LSIL) diagnosis. We tried to define a subgroup of "LSIL with atypical squamous cells of undetermined significance. High-grade squamous intraepithelial lesion (LASC-H)" in cervicovaginal screening which may aid in predicting the cases associated with high risk cannot be ruled out. In the years between 2001 and 2003 a total of 21,342 cervicovaginal smears were evaluated. The smears with pure LSIL and LASC-H diagnosis which had histologic follow-up were selected. The cases with diagnosis of LASC-H contained numerous typical cells of LSIL and only a few cells with features suggesting high-grade squamous intraepithelial lesion (HSIL). Eight (61%) of 13 cases with a diagnosis of LASC-H but three (11%) of 27 cases with a diagnosis of pure LSIL resulted in CIN 2-3 histology (p < 0.05). Diagnosis of LASC-H may be a valid diagnostic category in distinguishing patients with LSIL that would have HSIL in follow-up.
Department of Pathology, Zeynep Kamil Maternity Hospital, Istanbul, Turkey.
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Kir
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Cetiner
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Gurbuz
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Karateke
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D016009:Chi-Square Distribution; D003581:Cytodiagnosis / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000473:pathology*