[Controversies in the Bethesda System. To diagnose atypical squamous cells of undetermined significance (ASCUS) or not to diagnose?].
The classification of pap smears according to the Bethesda System introduced to the cytologic diagnostics atypical squamous cells of undetermined significance (ASCUS). From the moment of the introduction this term arises many controversies because morphological criteria proposed for the determining ASCUS are very subjective. Even most experienced cytologists not always are able to correct diagnosis of ASCUS. There are also doubts in the clinical procedure connected with the recognition ASCUS. To diminish doubts to the minimum appeared several proposals categorization of ASCUS. The cytologic diagnosis of ASCUS is a serious dilemma both clinical and considerable economic problem. There are suggestions of the elimination from the Bethesda System recognition ASCUS. Many authors it maintains that there is no reason to qualify atypical cells as ASCUS because it can be an image of the occurrence cervical intraepithelial neoplasia (CIN). The hope is that the three-dimensional microscopy, HPV DNA testing, cellular biomarkers, involvement of the cytology to colposcopic research considerably will decrease the number of incorrect diagnoses of ASCUS with the advantage for the clinical procedure. In light of opinions introduced in this paper it appears that the diagnostics ASCUS is legitimate. It is necessary to perform precise microscopic analysis of morphology observed cellules. The recognition of ASCUS one ought to place only exceptionally remembering simultaneously about clinical consequences of such diagnosis.
Malarewicz
Andrzej
A
Zakład Perinatologii Instytutu Kształcenia Medycznego Akademii Swietokrzyskiej w Kielcach, Kielce. andrzejmalarewicz@interia.pl
D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D065006:Papanicolaou Test; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology; D014626:Vaginal Smears