title: Clinical significance of atypical squamous cells of undetermined significance in detecting preinvasive cervical lesions in post- menopausal Turkish women.
abstract: BACKGROUND
  To evaluate the clinical significance of atypical squamous cells of undetermined significance (ASCUS) in PAP test in post-menopausal women and compare with reproductive age women.
  
  
  METHODS
  A total of 367 patients who referred to our gynecologic oncology clinic were included to the study between September 2012 and August 2013. Data for 164 post-menopausal (group 1) and 203 pre-menopausal (group 2) women with ASCUS cytology were evaluated retrospectively. Immediate colposcopy and endocervical curettage was performed for both groups and conization for all women with a result suggestive of CIN2-3. Histopathological results and demographic features of patients were compared between the two groups.
  
  
  RESULTS
  Mean age of the patients was 54.6±6.5 years in group 1 and 38±6.6 years in group 2. Some 14 (8.5%) of post- menopausal women and 36 (17.7%) of pre-menopausal women were current smokers (p=011). Totals of 38 (23.2%) post-menopausal and 64 (31.5%) pre-menopausal women were assessed for HPV-DNA. High risk HPV was detected in 7 (4.3%) and 21 (10.3%), respectively (p=0.029). Final histopathological results recorded were normal cervix, low grade cervical intra-epithelial neoplasia (CIN 1), and high grade cervical intra-epithelial neoplasia (CIN2-3). In group 1 results were 84.8%, 12.2% and 1.8%, respectively, and in group 2 were 71.9%, 23.2% and 4.9%. There were no cases of micro invasive or invasive cervical carcinoma in either group. Two cases were detected as endometrial carcinoma in the menopausal group (1.2%).
  
  
  CONCLUSIONS
  In current study we found that preinvasive lesions were statistically significantly higher in pre-menopausal women than post- menopausal women with ASCUS. Cervicitis was more common in menopausal women. Therefore, we think that in case of ASCUS in a post-menopausal woman there is no need for radical management.
authors.affiliation: Obstetrics and Gynecology, Medicine, Dr Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey E-mail : aytekintokmak@gmail.com.
authors.forename: Aytekin
authors.initials: A
authors.lastname: Tokmak
authors.forename: Ali Irfan
authors.initials: AI
authors.lastname: Guzel
authors.forename: Emre
authors.initials: E
authors.lastname: Ozgu
authors.forename: Murat
authors.initials: M
authors.lastname: Oz
authors.forename: Serap
authors.initials: S
authors.lastname: Akbay
authors.forename: Salim
authors.initials: S
authors.lastname: Erkaya
authors.forename: Tayfun
authors.initials: T
authors.lastname: Gungor
mesh_terms: D000328:Adult; D065309:Atypical Squamous Cells of the Cervix; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D016022:Case-Control Studies; D002584:Cervix Uteri / Q000601:surgery; D003127:Colposcopy; D019092:Conization; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D030361:Papillomavirus Infections / Q000453:epidemiology*; D017698:Postmenopause; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology