A Comparison of Cytomorphological Features of ASC-H Cells Based on Histopathological Results Obtained from a Colposcopic Target Biopsy Immediately after Pap smear Sampling

Abstract

Background: To compare the cytomorphological features of atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H) observed in a liquid-based Pap smear with the histopathological features observed in a concurrent colposcopic biopsy specimen obtained immediately after obtaining the Pap smear. Methods: Cytomorphological features such as cytoplasmic differentiation, nuclear/cytoplasm (N/C) ratio, chromatin pattern, thickening of nuclear contour, and the appearance of the nucleolus of 247 ASC-H obtained from 25 liquid-based Pap smear ASC-H cases were compared with those of the cells obtained from biopsied samples. Human papillomavirus (HPV) infection was tested for 39 HPV genotypes using Uniplex E6/E7 polymerase chain reaction method. Results: Of the 25 ASC-H cases, 22 (88%) showed cervical intraepithelial neoplasia grade 1 or greater (CIN1+) and 3 (12%) were benign. HPV infection was detected in 100% CIN1+ cases and 66.7% benign cases. Significant differences such as marked hyperchromasia, thickened nuclear contour, and prominent nucleoli were observed between ASC-H cases with CIN1+ and the benign cases. Conclusion: The presence of small dysplastic cells displaying marked hyperchromasia, thickening of nuclear contour, and prominent nucleoli on Pap smear strongly suggest the presence of CIN in ASC-H cases.

Positive Linear Relationship between Nucleophosmin Protein Expression and the Viral Load in HPV-Associated Oropharyngeal Squamous Cell Carcinoma: A Possible Tool for Stratification of Patients

“…Further, hyperchromasia, thickening of nuclear contour, and prominent nucleoli on Pap smear have been used as indicators of intraepithelial neoplasia grade 1 (CIN1) or greater CIN 2–3 [ 26 ]. Moreover, AgNOR areas and p16INK4a positivity have been associated with HR-HPV for the development of cervical cancer [ 27 ].…”

“…In keeping with the nucleolar role of HPV infection, changes in numbers or in mor-phometric parameters of silver-stained nucleolar organizer regions (AgNORs) have been previously proposed as useful predictors of worse prognosis in different forms of HPV- infected squamous cell carcinomas [ 22 , 23 , 24 , 25 ]. Recently, the presence of hyperchromasia, thickening of nuclear contour, and prominent nucleoli on Pap smear have been proposed as strong indicators of the presence of intraepithelial neoplasia grade 1 (CIN1) or greater CIN 2-3 [ 26 ]. Indeed, AgNOR areas greater than 3.3 µm 2 with concomitant expression of p16INK4a have been shown to be useful in the identification of high-risk human papillomaviruses (HR-HPV) for the development of cervical cancer [ 27 ].…”

High-resolution anoscopy for the diagnosis and treatment of human papillomavirus-related anal intraepithelial neoplasia in human immunodeficiency virus-seropositive men who have sex with men in Japan

“…APS is divided into negative intraepithelial lesions or malignancy (NILM) and atypical squamous cells (ASC), and ASC is further divided into ASC of indeterminate significance (ASC-US) and ASC of high-grade squamous lesions (ASC-H). 5 More severe ASCs are defined as squamous intraepithelial lesions (SILs) and are classified as low-grade SIL (LSIL) and high-grade SIL (HSIL). These findings suggest the presence of precancerous lesions and are considered positive by APS screening if they are ASC-US or higher.…”