Clinical Impact of Atypical Squamous Cells of Undetermined Significance

Lousuebsakul, Vichuda; Knutsen, Synnove M.F.; Gram, Inger Torhild; Akin, Marie-Rose M.

doi:10.1159/000326220

Cited by 18 publications

(14 citation statements)

References 13 publications

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“…26 -28 In some cytology laboratories an ASCUS diagnosis predicts histologic SIL at a rate almost equivalent to a low-grade squamous intraepithelial lesion (LSIL) cytologic diagnosis. 10,17 It is, therefore, argued that many of the ASCUS cases should have been diagnosed as LSIL. The management of patients with an indeterminate cervicovaginal smear diagnosis has, perhaps not surprisingly, remained controversial.…”

Section: Discussionmentioning

confidence: 99%

Long‐term follow‐up of women with atypical squamous cells of undetermined significance (ASCUS)

Emerson

Puzanov

Brunnemer

et al. 2002

Diagnostic Cytopathology

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ASCUS is the most common epithelial abnormality diagnosed in cytology laboratories in the US. Recently, the clinical importance of this diagnosis has been seriously questioned, with some investigators advocating elimination of this diagnostic category. This might be inappropriate if the ASCUS designation does define a population that is at significant risk for the development of dysplasia. Cytology and surgical pathology reports for all patients diagnosed as ASCUS in our laboratory during 1990 were reviewed. Patients with previous dysplasia or carcinoma were excluded from analysis. The pathology reports for the subsequent 9.1 yr were obtained and follow-up data collected. In 1990, 15,860 cervical cytology cases were examined in our laboratory. A diagnosis of ASCUS was made in 1,117 cases (7.0%). After excluding 345 patients with previous dysplasia or human papillomavirus-related diagnoses and 129 patients with no follow-up specimens, 643 study patients remained. Among these, the mean number of subsequent cervical smears was 4.3 (range, 1-18). Subsequent histologic material was available for 134 (20.8%) patients and the mean number of surgical specimens was 1.5 (range, 1-10). Squamous intraepithelial lesion (SIL) or dysplasia was subsequently diagnosed in 197 patients (30.6%). High-grade squamous intraepithelial lesion (HSIL) or at least moderate dysplasia was diagnosed in 64 patients (10.0%). In 21 cases (3.3%) the high-grade dysplasia developed more than 2 yr after the first ASCUS diagnosis. Follow-up disclosed no cases of invasive carcinoma. Among ASCUS patients followed for up to 9 yr, 20% develop only low-grade SIL or mild dysplasia and 10% develop HSIL or moderate or severe dysplasia. ASCUS should be retained as a diagnostic category since it identifies a significant percentage of patients who are at an increased risk for the development of cervical dysplasia.

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Section: Discussionmentioning

confidence: 99%

Long‐term follow‐up of women with atypical squamous cells of undetermined significance (ASCUS)

Emerson

Puzanov

Brunnemer

et al. 2002

Diagnostic Cytopathology

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“…The diagnosis of ASC has a significant clinical impact as approximately 40% of ASC cases are found to be SILs after biopsy, and therefore warrant ongoing follow-up 16,17. Since the introduction of the term "ASCUS" into the 1988 TBS, the cytomorphologic criteria for ASC/ASCUS categorization have been well-documented in many studies and their diagnostic accuracy precisely evaluated 14,18…”

Section: Discussionmentioning

confidence: 99%

Comparison of Diagnostic Cytomorphology of Atypical Squamous Cells in Liquid-Based Preparations and Conventional Smears

Lee

et al. 2012

Korean J Pathol

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BackgroundThe aims of this study were to compare the cytomorphologic features diagnostic of atypical squamous cells (ASC) in liquid-based preparations (LBPs) and conventional Pap (CP) smears and to cytomorphologically assess the performance of the Cell Scan 1500™ in cervical cytology practice.MethodsCervicovaginal smears were obtained from 938 women. Two smears were obtained simultaneously from each individual, one for an LBP and the other for a CP smear; the smears were independently examined. ASC was diagnosed in 24 patients, and their samples were cytomorphologically and semiquantitatively analyzed.ResultsA total of 24 of the 938 women (2.6%) were diagnosed with ASC by one or both methods. Results from LBPs and CP smears were in agreement in 13 of 24 cases of ASC diagnosis (absolute direct agreement, 54.2%; k<0.20; p-value from chi-square test=0.085). Diagnostic features of ASC in the LBPs included squamous cell atypia and atypical squamous metaplasia.ConclusionsThe cellular features diagnostic of ASC present in one preparation can manifest themselves differently in the other. Changes in individual cells, particularly nuclear changes, are the most reliable features for diagnosing ASC. The Cell Scan 1500™ processor is more effective at detecting ASC than are CP smears.

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“…Montz et al(1992) encontraram 19% de lesões intra-epiteliais escamosas em 91 casos em avaliação cito-histológica, enquanto Dvorak et al(1999) obtiveram 18% de casos de NIC em amostra de 249 pacientes e Collaço et al(2000) encontraram 45% de NIC, 51% de cervicite acentuada e metaplasia escamosa e 4% de carcinoma invasor. Corroborando este último estudo, Lousuebsakul et al(2000) encontraram 47% de lesões intra-epiteliais e 34% de alterações reativas em 421 casos, reforçando a diversidade de formas de lesões que alberga a categoria de alterações de significado indeterminado (12) .…”

Section: Discussionunclassified

Estudo das atipias indeterminadas em relação à prevalência e ao percentual de discordância nos casos do Programa de Prevenção do Câncer Uterino do Paraná

Sebastião¹,

Noronha²,

Scheffel³

et al. 2004

J. Bras. Patol. Med. Lab.

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Clinical Impact of Atypical Squamous Cells of Undetermined Significance

Cited by 18 publications

References 13 publications

Long‐term follow‐up of women with atypical squamous cells of undetermined significance (ASCUS)

Long‐term follow‐up of women with atypical squamous cells of undetermined significance (ASCUS)

Comparison of Diagnostic Cytomorphology of Atypical Squamous Cells in Liquid-Based Preparations and Conventional Smears

Estudo das atipias indeterminadas em relação à prevalência e ao percentual de discordância nos casos do Programa de Prevenção do Câncer Uterino do Paraná

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