ASC-H cytological result: clinical relevance and accuracy of colposcopy in predicting high-grade histological lesions—a 7-year experience of a single institution in Portugal

Marujo, Ana Teresa; Correia, Lúcia; Brito, Marta; Paula, Tereza; Borrego, Jorge

doi:10.1016/j.jasc.2017.07.004

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…In general it is well documented that the size of the lesion corresponds to its severity . This fact correlates with the increased risk of cervical dysplasia in our group of patients.…”

Section: Discussionsupporting

confidence: 72%

Colposcopic scoring indexes in the evaluation of cervical lesions with the cytological result of atypical squamous cells, cannot exclude high‐grade lesion

Kúdela

Laučeková

Ňachajová

et al. 2019

J of Obstet and Gynaecol

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Aim: Colposcopic indexes including Reid index and Swede score were developed to make the colposcopy more objective. The aim of our study was to evaluate the significance of colposcopic indexes in the evaluation of ASC-H cervical lesions. Methods: We carried out a cross-sectional study in the Clinic of Obstetrics and Gynecology between January 2013 and December 2018. The study included 535 women, from which 66 women had a cytological result ASC-H. Scoring of all colposcopic findings was assessed according to Reid modified index and Swede score and a composite score was determined. Frequency distributions were compared using χ 2 /Fisher exact test. Spearman rank correlation coefficient was computed between RCI and Swede score. Results: Sensitivity, specificity, positive and negative predictive value and positive likelihood ratio of modified Reid colposcopic index at a cutoff of ≥4 for the detection of HSIL+ lesions were: 86.11% (95% CI: 70.5-95.3), 83.33% (95% CI: 65.3-94.4), 86.11% (95% CI: 69.7-94.8), 83.33% (95% CI: 64.5-93.7) and 5.17 (95% CI: 2.3-11.6). Swede score with the cutoff value ≥5 showed comparable results to modified Reid index with the increased sensitivity: 94.44% (95% CI: 81.3-99.3). Conclusion: ASC-H category represents the trickiest cytological diagnosis as it is underlined with the high risk of severe cervical dysplasia. Evaluating the cervical lesion by the use of colposcopic indices helps the gynecologist to objectively evaluate all the pathologies of uterine cervix. Swede score with the cutoff value 8 also enables a 'see and treat' option in management of atypical squamous cells, cannot exclude high-grade lesions.

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“…In general it is well documented that the size of the lesion corresponds to its severity . This fact correlates with the increased risk of cervical dysplasia in our group of patients.…”

Section: Discussionsupporting

confidence: 72%

Colposcopic scoring indexes in the evaluation of cervical lesions with the cytological result of atypical squamous cells, cannot exclude high‐grade lesion

Kúdela

Laučeková

Ňachajová

et al. 2019

J of Obstet and Gynaecol

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“…Indeed, there could be microscopic CIN2 + lesions not visible to the human eye or by colposcopy examination, but that still could be detected by cytology or the HR-HPV test, which would have led to false categorization, as false positives. Indeed colposcopy is not sufficiently precise, although useful in estimating lesion grade [41][42][43][44]. Nevertheless, most studies, like us, determine the final negative status of the cervix for CIN 2 through colposcopy when lesion is not evident, and use this result as a true negative clinical condition [32,[45][46][47].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the effectiveness of high-risk human papilloma self-sampling test for cervical cancer screening in Bolivia

et al. 2020

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Background: In Bolivia the incidence and mortality rates of uterine cervix cancer are the highest in America. The main factor contributing to this situation is the difficulty of establishing and maintaining quality prevention programs based on cytology. We aimed to evaluate the effectiveness of HR-HPV testing on self-collected samples to detect cervical intra-epithelial neoplasia and identify the best combination of screening tests. Methods: A total of 469 women, divided in two groups, were included in this study. The first group included 362 women that underwent three consecutively primary screening tests: self-collected sampling for HR-HPV detection, conventional cervical cytology and visual inspection under acetic acid (VIA). The second group included 107 women referred with a positive HR-HPV test that underwent conventional cervical cytology and VIA. The presence of high grade intraepithelial lesion (CIN 2+) or invasive cancer was verified by colposcopy and biopsy. Result: In the screening group the sensitivity to detect high grade intraepithelial lesion (CIN 2+) or invasive cancer were 100, 76, 44% for the VIA, HR-HPV test and cytology, respectively. In the referred group, the sensitivity to detect high grade intraepithelial lesion (CIN 2+) or invasive cancer by VIA and cytology were 100 and 81%, respectively. Conclusions: VIA and HR-HPV self-sampling were the best combination to detect CIN2+ lesions. Cytology analysis gave the poorest performance.

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“…Colposcopy is advised for all the women in who are diagnosed withhigh-grade squamous intraepithelial lesion (HSIL) and atypical squamous cells-cannot exclude highgrade squamous intraepithelial lesion (ASC-H) for cervical cancer screening (6). It is also recommended for high-risk HPV (HR HPV) positive women with ASCUS.…”

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confidence: 99%

Is it Really Necessary to Perform Colposcopy in Patients with Ascus and HR HPV Positivity?

Ozaltin

2022

Acibadem Univ Saglik Bilim Derg

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IS IT REALLY NECESSARY TO PERFORM COLPOSCOPY IN PATIENTS WITH ASCUS AND HR HPV POSITIVITY? INTRODUCTION: Papanicolaou (Pap) smear is a very important screening method for detection of cervİcal cancer or cell changes that can lead to it. Atypical squamous cells of undetermined significance (ASCUS) is the most common abnormality seen among all cervical cytologies with the percentage of 4-5% . Human papillomavirus (HPV) infection is regarded as a major cause of cervical intraepithelial neoplasia (CIN) and cervical cancer. Colposcopy is recommended for all women with high-grade squamous intraepithelial lesion (HSIL) and atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H) for cervical cancer screening . It is also recommended for high-risk HPV (HR HPV) positive women with ASCUS. The aim of this study is to evaluate the importance of colposcopy in patients with ASCUS and HR HPV positivity. MATERIALS AND METHODS: Study Population We performed a retrospective study approved by the ethics committee of Acıbadem University. Women with diagnosis of ASCUS and HR HPV positivity who underwent colposcopic evaluation at 2 different gynecologic oncology clinics of our university from January 2011 to January 2019 were included in our study. The age range was from 21 to 48 and the mean age of patients’ was 29. Subjects who were pregnant, hysterectomized or had previous cytological abnormalities were excluded. CONCLUSION: In this study, we aimed to evaluate the significance of colposcopy in patients with ASCUS and high-risk HPV positivity, especially strains 16 and 18. As mentioned in some other studies, immediate colposcopy is an expensive screening procedure for further evaluation of ASCUS .

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ASC-H cytological result: clinical relevance and accuracy of colposcopy in predicting high-grade histological lesions—a 7-year experience of a single institution in Portugal

Cited by 3 publications

References 19 publications

Colposcopic scoring indexes in the evaluation of cervical lesions with the cytological result of atypical squamous cells, cannot exclude high‐grade lesion

Colposcopic scoring indexes in the evaluation of cervical lesions with the cytological result of atypical squamous cells, cannot exclude high‐grade lesion

Evaluation of the effectiveness of high-risk human papilloma self-sampling test for cervical cancer screening in Bolivia

Is it Really Necessary to Perform Colposcopy in Patients with Ascus and HR HPV Positivity?

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