title: Atypical squamous cells of undetermined significance: Bethesda classification and association with Human Papillomavirus.
abstract: BACKGROUND
  To analyze patients with atypical squamous cells of undetermined significance (ASCUS) through a cytology review and the presence of microbiological agents, with consideration of colposcopy and semiannual tracking.
  
  
  METHODS
  103 women with ASCUS were reviewed and reclassified: normal/inflammatory, ASCUS, low-grade squamous intraepithelial lesion (LSIL), or high-grade squamous intraepithelial lesion (HSIL). If ASCUS confirmed, it was subclassified in reactive or neoplastic ASCUS, ASC-US, or ASC-H; and Regione Emilia Romagna Screening Protocol. Patients underwent a colposcopic examination, and test for Candida sp., bacterial vaginosis, Trichomonas vaginalis, and human papillomavirus (HPV) were performed.
  
  
  RESULTS
  Upon review, ASCUS was diagnosis in 70/103 (67.9%), being 38 (54.2%) reactive ASCUS and 32 (45.71%) neoplastic ASCUS; 62 (88.5%) ASC-US and 8 (11.41%) ASC-H. ASCUS (Regione Protocol), respectively 1-5: 15 (21.4%), 19 (27.1%), 3 (27.1%), 16 (22.8%), and 1 (1.4%). A higher number of cases of cervical intraepithelial neoplasia (CIN) II/III in the biopsies of patients with ASC-H compared to ASC-US (P = .0021). High-risk HPV test and presence of CIN II/III are more frequent in ASC-H than ASC-US (P = .031).
  
  
  CONCLUSIONS
  ASC-H is associated with clinically significant disease. High-risk HPV-positive status in the triage for colposcopy of patients with ASC-US is associated with increased of CIN.
authors.affiliation: Discipline of Gynecology and Obstetrics, Oncology Research Institute, Uberaba, MG, Brazil.
authors.forename: Ana Cristina Macêdo
authors.initials: AC
authors.lastname: Barcelos
authors.forename: Márcia Antoniazi
authors.initials: MA
authors.lastname: Michelin
authors.forename: Sheila Jorge
authors.initials: SJ
authors.lastname: Adad
authors.forename: Eddie Fernando Candido
authors.initials: EF
authors.lastname: Murta
mesh_terms: D000293:Adolescent; D000328:Adult; D052685:Alphapapillomavirus / Q000302:isolation & purification*; D003127:Colposcopy; D005260:Female; D006801:Humans; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000473:pathology* / Q000821:virology; D011446:Prospective Studies; D012720:Severity of Illness Index; D002578:Uterine Cervical Dysplasia / Q000473:pathology* / Q000821:virology*; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000821:virology; D014626:Vaginal Smears