title: Clinical significance of cytologic diagnosis of atypical squamous cells, cannot exclude high grade, in perimenopausal and postmenopausal women.
abstract: We used cytohistologic correlation to determine the clinical significance of atypical squamous cells, cannot exclude high grade (ASC-H) in perimenopausal and postmenopausal women. A computer search identified 250 Papanicolaou smears from women older than 45 years with a diagnosis of ASC- H. Cases were considered perimenopausal (45 to < 55 years; 150 cases) and postmenopausal ((3)55 years; 100 cases). No follow-up data were available for 33 cases, which were excluded. The remaining 217 cases (perimenopausal, 127; postmenopausal, 90) had surgical or cytologic follow-up. Results of follow-up colposcopic biopsy were available for 176 (81.1%) and cytology for 41 (18.9%) women. Follow-up results were as follows: perimenopausal women, negative, 50 (39.4%); mild dysplasia (low-grade squamous intraepithelial lesion [LSIL]), 46 (36.2%); high-grade dysplasia (high-grade SIL [HSIL]); 28 (22.0%); and ASC of undetermined significance (ASC-US), 3 (2.4%); postmenopausal women, negative, 52 (58%); LSIL, 31 (34%); HSIL, 5 (6%); and ASC-US, 2 (2%). The diagnosis of ASC-H in postmenopausal women usually is associated with LSIL or a negative diagnosis on follow-up, suggesting a less aggressive surveillance and treatment regimen is needed for postmenopausal women with ASC-H.
authors.affiliation: Department of Pathology, Allegheny General Hospital and Drexel University College of Medicine, Pittsburgh, PA 15212, USA.
authors.forename: Reda S
authors.initials: RS
authors.lastname: Saad
authors.forename: David J
authors.initials: DJ
authors.lastname: Dabbs
authors.forename: Lana
authors.initials: L
authors.lastname: Kordunsky
authors.forename: Amal
authors.initials: A
authors.lastname: Kanbour-Shakir
authors.forename: Jan F
authors.initials: JF
authors.lastname: Silverman
authors.forename: Yulin
authors.initials: Y
authors.lastname: Liu
authors.forename: Anisa
authors.initials: A
authors.lastname: Kanbour
mesh_terms: D000368:Aged; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D008875:Middle Aged; D018307:Neoplasms, Squamous Cell / Q000175:diagnosis*; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000302:isolation & purification; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears
chemical_list: D004279:DNA, Viral