Cytopathology update on atypical squamous cells.
The most common abnormality reported by cervical cytology (Pap tests) is atypical squamous cells (ASC). The two subcategories are ASC of undetermined significance (ASCUS) and ASC, cannot exclude high-grade squamous intraepithelial lesion (ASC-H). ASCUS show morphology suspicious for a low-grade lesion, while ASC-H cells are suspicious for a high-grade process. ASCUS account for most ASC reports, and the 2002 median ASCUS reporting rates were 3.1% for conventional smears and 4.1% for liquid-based preparations. Reporting rates for squamous intraepithelial lesions and cancer (SIL+) were also higher for liquid-based preparations, and thus the median ASC/SIL+ ratio was lower for liquid-based preparations (1.27) than for conventional smears (1.44). Interobserver reproducibility for ASC is generally considered lower than for other squamous epithelial abnormalities. Women with ASCUS may be managed by human papillomavirus DNA testing, repeated cytology, or colposcopy, while women with ASC-H should generally proceed to colposcopy.
Davey
Diane D
DD
Department of Pathology and Laboratory Medicine, University of Kentucky Medical Center, Lexington, Kentucky 40536-0298, USA. ddavey@uky.edu
D000570:American Cancer Society; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000517:prevention & control; D003581:Cytodiagnosis / Q000379:methods; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods; D008499:Medical Records; D009367:Neoplasm Staging; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000175:diagnosis; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000517:prevention & control
D004279:DNA, Viral