Clinical Significance of Cytologic Diagnosis of Atypical Squamous Cells, Cannot Exclude High Grade, in Perimenopausal and Postmenopausal Women

Follow up of Atypical Squamous Cell Pap Smears in Iraqi Women

“…Saad et al who tracked patients with ASC-H for 18 months, reported higher HSIL rate among perimenopausal women (22%) but much lower rate among postmenopausals (6%) (Saad et al, 2006) a finding that has been further documented by others (Chivukula and Shidham, 2006;Sherman et al, 2006;Bandyopadhyay et al, 2008;Zhao et al, 2010). Nevertheless, in the present study we experienced a significantly higher LSIL and HSIL rates with higher HSIL: LSIL ratio among ASC-H group than ASC-US.…”

“…The wide ranges of ASC-US (1.2-39%) and, to a lesser extent, ASC-H (0.06-2%) may be contributed to the Bethesda system applied for categorization of ASC into ASC-US and ASC-H and further subcategorization of ASC-US into reactive and neoplastic counterparts (NCI Bethesda System, 2001;Solomon et al, 2001Selvaggi, 2003Barcelos et al, 2011). In addition, the heterogeneous morphology and lack of well-defined criteria for both ASC-US and ASC-H reflected in their poor interobserver agreement between laboratories or even the variable experience of the microscopists may account for these differences (Saad et al, 2006;Chivukula and Shidham;CytrynI et al, 2009;Tewari and Chaudhary., 2010;Barcelos et al, 2011). The rate of Pap smears could be also influenced by the type of Pap test applied, the age group of the studied patients as well as the population sampled (Chivukula and Shidham, 2006;Saad et al, 2006;Sherman et al, 2006;Bandyopadhyay et al, 2008;Tewari and Chaudhary, 2010;Zhao et al, 2010).…”

“…However, referring all women with minor cytologic lesions for colposcopic exploration and further evaluation means an increase in overdiagnosis and overtreatment, and this may result in substantial costs for the health care system Chivukula and Shidham, 2006;Bandyopadhyay et al, 2008;Tewari and Chaudhary, 2010;Barcelos et al, 2011). Saad et al (2006), Srodon et al (2005) and Sherman et al (2006) suggested that HPV testing may be helpful for selecting patients with ASC-H who should undergo colposcopic examination. The presence of higher rates of CIN II/III among HPV-positive ASC-US in a study done by Barcelos et al (2011) in Brazil and among HPV-positive ASC-H group in another study done in US by Srodon et al' (2005) study suggest that HPV positivity may be associated with an increased probability of CIN among both groups.…”

“…Variations in HR-HPV DNA association with both ASC-US and ASC-H women have been reported (Table 6). These variations may reflect the significant differences in cytologic interpretation thresholds for ASC-US and ASC-H interpretations (Chivukula and Shidham, 2006;Saad et al, 2006;Bandyopadhyay et al, 2008). HR-HPV rate variation is further contributed to the impact of employing different techniques for HPV DNA identification (de Roda Husman et al, 1995;Jacobs et al, 1997;Sherman et al, 2001;van den Brule et al, 2002;Saad et al, 2006;Bandyopadhyay et al, 2008;Zhao et al, 2010).…”

Histopathological Outcomes of Women with Abnormal Cervical Cytology: a Review of Literature in Thailand

“…In the recent study by Kingnate et al (2014), incidence of CIN 2-3/AIS and invasive lesion was 10.5% and 2.6%, respectively. In the literature, almost all studies evaluating histopathologic results of ASC-H smears were reported from North America where the incidence of cervical cancer appears to be relatively low (Alli and Ali, 2003;Louro et al, 2003;Selvaggi, 2003;Liman et al, 2005;Barreth et al, 2006;Saad et al, 2006;Srodon et al, 2006;McHale et al, 2007). The rate of underlying high-grade cervical lesion varied widely from 10% to 80%, in which less than 3.5% were invasive lesion (Alli and Ali, 2003;Louro et al, 2003;Selvaggi, 2003;Liman et al, 2005;Barreth et al, 2006;Saad et al, 2006;Srodon et al, 2006;McHale et al, 2007).…”