title: Cytologic features of high-grade squamous intraepithelial lesion in conventional slides: what is the difference between cases that perform well and those that perform poorly?
abstract: BACKGROUND
  Previous studies have suggested that cases of high-grade squamous intraepithelial lesion in conventional smears and in ThinPrep specimens that are frequently misinterpreted as normal have relatively few small and hypochromatic dysplastic cells.
  
  
  OBJECTIVE
  To determine the cytologic differences between conventional Papanicolaou slides of high-grade squamous intraepithelial lesion that perform poorly and those that perform well.
  
  
  METHODS
  We compared the cytologic features of 22 cases of conventional smears with high-grade squamous intraepithelial lesion that performed poorly in the College of American Pathologists Interlaboratory Comparison Program in Gynecologic Cytology with 45 cases of conventional smears that performed extremely well.
  
  
  RESULTS
  Cases that performed poorly were significantly more likely to have 50 or fewer single dysplastic cells (P = .003) and to have only small dysplastic cells (P = .01). Cases that performed well were also more likely to have more than 500 dysplastic cells (P = .002), to exhibit the presence of large dysplastic cells (P < .001), and to be keratinized (P = .03). Hypochromasia and the number of groups of dysplastic cells were not correlated with performance.
  
  
  CONCLUSIONS
  Conventional smears with high-grade squamous intraepithelial lesion with 50 or fewer single dysplastic cells, no large dysplastic cells, and lacking keratinization are highly associated with poor performance in this program.
authors.affiliation: Department of Pathology, Baptist Hospital of Miami, Miami, Fla 33176-2197, USA. Andrewr@bhssf.org
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Renshaw
authors.forename: Marianne U
authors.initials: MU
authors.lastname: Prey
authors.forename: Lori
authors.initials: L
authors.lastname: Hodes
authors.forename: Maggie
authors.initials: M
authors.lastname: Weisson
authors.forename: Jennifer
authors.initials: J
authors.lastname: Haja
authors.forename: Ann T
authors.initials: AT
authors.lastname: Moriarty
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000145:classification / Q000378:metabolism / Q000473:pathology*; D002452:Cell Count; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D007633:Keratins / Q000378:metabolism; D065006:Papanicolaou Test; D010338:Pathology, Clinical / Q000379:methods; D002578:Uterine Cervical Dysplasia / Q000145:classification / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology*; D002583:Uterine Cervical Neoplasms / Q000145:classification / Q000378:metabolism / Q000473:pathology*; D014626:Vaginal Smears / Q000379:methods*
chemical_list: D007633:Keratins