title: Clinical relevance of atypical squamous cells of undetermined significance by the 2001 bethesda system: experience from a cervical cancer high incidence region.
abstract: The aim of this study was to evaluate the underlying lesions and factors predicting cervical intraepithelial neoplasia (CIN) 2+ in women who had 'atypical squamous cells of undetermined significance' (ASC-US) on cervical cytology in the region with a high incidence of cervical cancer. This study was prospectively conducted at Chiang Mai University Hospital, Chiang Mai, Thailand. All women with ASC-US cytology undergoing colposcopic evaluation between October 2004 and August 2008 were recruited. During the study period, 208 women were enrolled. Mean age was 44.4 years. The histopathologic results at the initial evaluation were as follows: CIN 2-3, 21 (10.1%); adenocarcinoma in situ, 3 (1.4%); cancer, 5 (2.4%); CIN 1, 26 (12.5%); and no lesions, 153 (73.6%). Multivariate analysis revealed that nulliparity (adjusted odds ratio [aOR] =4.09; 95% confidence interval [CI] = 1.04-16.10) and current oral contraceptive use (aOR=2.85; 95%CI= 1.14-7.15) were independent predictors for having CIN 2+ at the initial colposcopy. At the median follow-up time of 6.7 months, CIN 2-3 lesions were additionally detected in 2 women. In conclusion, ASC-US cytology in our population has a relatively high prevalence of underlying invasive carcinoma. Nulliparity and current oral contraceptive use are independent predictors for harboring CIN 2+.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. nutjujuju@yahoo.com
authors.forename: Nuttavut
authors.initials: N
authors.lastname: Kantathavorn
authors.forename: Chumnan
authors.initials: C
authors.lastname: Kietpeerakool
authors.forename: Prapaporn
authors.initials: P
authors.lastname: Suprasert
authors.forename: Jatupol
authors.initials: J
authors.lastname: Srisomboon
authors.forename: Surapan
authors.initials: S
authors.lastname: Khunamornpong
authors.forename: Kanchana
authors.initials: K
authors.lastname: Nimmanhaeminda
authors.forename: Sumalee
authors.initials: S
authors.lastname: Siriaungkul
mesh_terms: D000328:Adult; D017677:Age Distribution; D001707:Biopsy, Needle; D002294:Carcinoma, Squamous Cell / Q000145:classification / Q000453:epidemiology / Q000473:pathology*; D015331:Cohort Studies; D003127:Colposcopy / Q000145:classification; D003581:Cytodiagnosis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013785:Thailand / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000145:classification / Q000453:epidemiology / Q000473:pathology*; D014626:Vaginal Smears / Q000145:classification; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000145:classification / Q000453:epidemiology / Q000473:pathology*