Cytology and outcome of LSIL: cannot exclude HSIL compared to ASC-H.
OBJECTIVE
The cytological features associated with clinical outcome of 'LSIL cannot exclude HSIL (LSIL-H)' in comparison with 'atypical squamous cells cannot exclude HSIL (ASC-H)' are incompletely described.


METHODS
LSIL-H and ASC-H Pap tests reported in a regional laboratory during a 13-month period were reviewed by two pathologists. Cytological features suspicious for HSIL were evaluated against a check list of 52 atypical features. All histology over 2 years of follow up for tests reclassified as LSIL-H and ASC-H was retrieved to determine clinical outcome. Atypical cytological features were correlated with outcome.


RESULTS
The review yielded 89 LSIL-H and 86 ASC-H. The highest ranked atypical cytological feature in each group was increased nuclear cytoplasmic ratio. Clinical outcome was positive (CIN II/III or AIS) in 44 (49%) LSIL-H and 33 (38%) ASC-H. Round (P = 0.02) and naked nuclei (P = 0.009) were significant correlates of outcome amongst LSIL-H tests, but no feature correlated with outcome in the ASC-H group.


CONCLUSIONS
LSIL-H is different to ASC-H because of the 11% higher frequency of a positive outcome and the cytological features associated with outcome.
Department of Pathology, University of Alberta, Calgary, Alberta, Canada.
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C
Hunter
M A
MA
Duggan
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Q
Duan
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Power
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J
Gregoire
J
J
Nation
D002584:Cervix Uteri / Q000473:pathology; D003127:Colposcopy; D005260:Female; D006801:Humans; D018307:Neoplasms, Squamous Cell / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D011230:Precancerous Conditions / Q000473:pathology; D016896:Treatment Outcome; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy