Clinical management of the first ASCUS report in Chile. Prospective single-cohort study

López-Alegría, Fanny; O, Poblete; Lorenzi, Dino Soares De; Oyanedel, Juan Carlos

doi:10.1590/1516-3180.2014.9142511

Cited by 9 publications

(14 citation statements)

References 23 publications

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“…In the population-based screening phase, it has been reported that ASC-US were found in <1% of the cases in a single population-based study (10). Solomon et al reported that <4% of U.S. women were given an equivocal cervical cytological diagnosis (ASC-US) annually (11).…”

Section: Discussionmentioning

confidence: 99%

Clinical significance of atypical squamous cells of undetermined significance after treatment for cervical intraepithelial grade?3 neoplasia: A retrospective single‑center cohort study

et al. 2017

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Abstract. The aim of the present study was to evaluate the clinical significance of atypical squamous cells of undetermined significance (ASC-US) following cervical conization for cervical intraepithelial neoplasia (CIN) grade 3. This study was a retrospective cohort analysis. The medical records of women treated with conization for CIN 2-3 were reviewed and 142 patients with CIN 3 who had been diagnosed using the conization specimens were selected. The mean follow-up period after conization was 41.8 months. Cytological abnormalities after conization were observed in 19.0% of the patients and consisted of ASC-US (13.4%) and worse than low-grade squamous intraepithelial lesion (LSIL; 5.6%). Recurrence was defined as a diagnosis worse than CIN 2, and the recurrence rate was 29.6% among patients with abnormal cytology. The recurrence rate was 15.7% in the ASC-US group and 71.4% in the worse than LSIL group. There was no significant difference in the time of initial identification of abnormal cytology after treatment between the worse than LSIL and the ASC-US groups (P= 0.054). However, the ASC-US group had a significantly better cumulative recurrence-free rate compared with the worse than LSIL group (P<0.05). Women with ASC-US following treatment for CIN appear to be at a relatively high risk. Regarding the risk stratification of women following treatment for CIN, if surveillance cytology shows ASC-US, immediate colposcopy is recommended, along with long-term follow-up.

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Section: Discussionmentioning

confidence: 99%

Clinical significance of atypical squamous cells of undetermined significance after treatment for cervical intraepithelial grade?3 neoplasia: A retrospective single‑center cohort study

et al. 2017

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“…The objective of the study of López-Alegría et al [21] was to determine the type of clinical management used among women with a first ASCUS Pap smear report. The authors found 446 women with a first ASCUS report.…”

Section: Discussionmentioning

confidence: 99%

“…The results of the biopsies showed that 16 women had negative histological reports, 13 had CIN 1, and 29 had CIN 2+. It was shown that repeat cytology is a safe procedure [21]. …”

Section: Discussionmentioning

confidence: 99%

Prevalence of High-Grade Intraepithelial Neoplasia in Patients with Cytology Presenting Atypical Squamous Cells of Undetermined Significance

Lopes¹,

Campaner²,

Henrique³

2016

Acta Cytologica

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Objectives: To evaluate the prevalence of histological high-grade lesions and cervical cancer in patients with ASCUS cytology. Methods: This is a cross-sectional prospective study involving 703 women with a uterus and atypical squamous cells of undetermined significance (ASCUS). The patients were submitted to a colposcopy and underwent a guided biopsy when changes on the colposcopy were detected. Results: The findings revealed 456 (64.9%) women with a normal colposcopy and 247 (35.1%) with colposcopic abnormalities. The biopsy results were: cervical intraepithelial neoplasia grade 1 (CIN 1) in 51 (20.6%) patients, CIN 2 in 11 (4.5%) patients, CIN 3 in 8 (3.2%) patients, and a negative result in 177 (71.7%) patients; no cases of cancer were detected. Tallying of 456 normal colposcopies and 177 negative biopsies yielded a total of 90.04% negative exams. Furthermore, around 7.2% (51/703) of the patients exhibited CIN 1, a lesion associated with a high potential for regression. The biopsy results were not associated with patient age or menopausal status. Conclusion: We conclude that cytological surveillance of patients with ASCUS is feasible and safe given the low risk of CIN 2/3 or cervical cancer.

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“…ASC-US is the most frequently reported cytological abnormality [9, 10] ranging from 1.6 to 9% of all smear tests [1]. These results rarely cause concerns that more significant lesions may be present since 1/3 to 2/3 are HPV negative [10, 11].…”

Section: Introductionmentioning

confidence: 99%

Atypical Squamous Cells: Cytopathological Findings and Correlation with HPV Genotype and Histopathology

Oliveira

Eleutério

et al. 2018

Acta Cytologica

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Objective: We aimed to assess potential associations between atypical squamous cell (ASC) subgroups: ASC-US (undetermined significance) and ASC-H (cannot exclude high-grade squamous intraepithelial lesion), regarding cytomorphological features, high-risk (HR) human papillomavirus (HPV) testing, and histological outcomes in a sample of Brazilian women. Study Design: Cross-sectional study which evaluated 1,346 liquid-based cytologies between January 2010 and July 2016 with ASC results. ASC-US and ASC-H were analyzed for frequency, diagnostic criteria, and cytological findings and compared with HR-HPV tests and histological outcomes. Results: Enlarged nucleus was the most frequent ASC-US criterion, but alternative criteria were present in 20% of the total cases. No ASC-US criteria were associated with histological outcomes or HR-HPV positivity. Parakeratosis, corneal pearl, giant cells, and binucleation were strongly associated with ASC-US while hyperkeratosis was associated with high-grade squamous intraepithelial lesions (HSIL) or a superior outcome. HR-HPV was positive in 64.39% of ASC-US and 65.38% of ASC-H. HSIL or superior outcomes also occurred in 13.33% of ASC-US and 64.71% of ASC-H cases. Conclusion: Alternative criteria for ASC-US were relatively frequent. Reactive cellular changes suggestive of atypias were more abundant in ASC-US. Although ASC-H is associated with worse histological outcomes, no differences in HPV positivity were found in comparison to ASC-US.

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Clinical management of the first ASCUS report in Chile. Prospective single-cohort study

Cited by 9 publications

References 23 publications

Clinical significance of atypical squamous cells of undetermined significance after treatment for cervical intraepithelial grade?3 neoplasia: A retrospective single‑center cohort study

Clinical significance of atypical squamous cells of undetermined significance after treatment for cervical intraepithelial grade?3 neoplasia: A retrospective single‑center cohort study

Prevalence of High-Grade Intraepithelial Neoplasia in Patients with Cytology Presenting Atypical Squamous Cells of Undetermined Significance

Atypical Squamous Cells: Cytopathological Findings and Correlation with HPV Genotype and Histopathology

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