Outcomes of women with atypical squamous cells of undetermined significance and high-risk human papillomavirus DNA.
OBJECTIVE
To study the risk of high-grade squamous intraepithelial lesion (HSIL) and cervical intraepithelial neoplasia (CIN) 2 or 3 in women with human papillomavirus (HPV)-positive atypical squamous cells of undetermined significance (ASCUS) cytology over a 2-year period using the 2001 Bethesda System and ThinPrep Paps.


METHODS
In 2002, 846 patients with ThinPrep cervical cytology having an ASCUS interpretation and positive for high-risk HPV DNA were identified. A cohort of 514 (60.8%) patients with follow-up by repeat cytology, cervical biopsy or both was included in the study. Patient age was 12-81 years, with a median of 25 years.


RESULTS
There were 291 women (56.6%) with negative status by cytology, HPV testing or biopsy with a median interval of 8.5 months, and an additional 174 patients (33.9%) had persistent ASCUS, positive HPV DNA or low-grade SIL/CIN 1. Finally, 49 patients (9.5%) had CIN 2 or 3, with a median interval of 8.5 months.


CONCLUSIONS
Our study suggests that HSIL or CIN 2 or 3 will be detected in 1 in 10 women with HPV-positive index ASCUS cervical cytology at initial colposcopy or within a 2-year follow-up period.
Feng
Jining
J
Department of Pathology and Cytopathology, Detroit Medical Center, Wayne State University, Detroit, Michigan 48201, USA. jfeng@dmc.org
Husain
Mujtaba
M
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D052685:Alphapapillomavirus / Q000235:genetics* / Q000302:isolation & purification*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000473:pathology; D002648:Child; D004279:DNA, Viral / Q000032:analysis* / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000473:pathology
D004279:DNA, Viral