title: Body mass index and outcome of ASC-H-interpreted cervical smears in postmenopausal women.
abstract: OBJECTIVE
  Patient age is one important factor used to evaluate the risk in women with ASC-H (atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion). This finding may be associated with atrophic changes reflecting a hypoestrogenic status and suggests that body mass index (BMI) can affect the outcome of ASC-H smears in postmenopausal women.
  
  
  METHODS
  We investigated the outcome of 154 postmenopausal women with an ASC-H smear and assessed relationships with BMI categories and serum estradiol levels.
  
  
  RESULTS
  In patients with higher BMI, an underlying squamous intraepithelial lesion (SIL) was more frequent than in patients with lower BMI, and a higher BMI was also associated with increased serum estradiol levels. When samples were classified by preparation method, these findings were more pronounced in liquid-based smears than in conventional smears. Principal component analysis using three factors (BMI, age and human papilloma virus status) revealed two distinct groups: those with a negative cervical smear and those with a smear result indicating SIL+.
  
  
  CONCLUSIONS
  Hormonal alterations can affect the outcome of ASC-H smears, and BMI is one factor that should be considered when evaluating the risk associated with ASC-H smears in postmenopausal women.
authors.affiliation: Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Soomin
authors.initials: S
authors.lastname: Ahn
authors.forename: Yoo-Young
authors.initials: YY
authors.lastname: Lee
authors.forename: Ji-Youn
authors.initials: JY
authors.lastname: Sung
authors.forename: Jae Jun
authors.initials: JJ
authors.lastname: Lee
authors.forename: Young Lyun
authors.initials: YL
authors.lastname: Oh
authors.forename: Chang Ohk
authors.initials: CO
authors.lastname: Sung
authors.forename: Sang Yong
authors.initials: SY
authors.lastname: Song
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology*; D015992:Body Mass Index; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000453:epidemiology / Q000473:pathology*; D015897:Comorbidity / Q000639:trends; D003430:Cross-Sectional Studies; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000453:epidemiology / Q000473:pathology*; D017698:Postmenopause / Q000502:physiology; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000097:blood / Q000453:epidemiology / Q000473:pathology*
chemical_list: D004958:Estradiol