The risk of CIN II or greater in a one-year follow-up period in patients with ASC-H interpreted with cytology

You, Ke; Guo, Yanli; Li, Gen; Qiao, Jie

doi:10.1016/j.ejogrb.2009.12.034

Cited by 7 publications

(8 citation statements)

References 22 publications

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“…ASCUS+ detected at an interval of 6 months or longer has been associated with incident CIN1, CIN2 or SIL (27), and in 20% of women with persistent LSIL progressed to HSIL or cervical cancer during 8 years of follow‐up (23). With atypical squamous cells suggesting HSIL, this association is even stronger; 40% of women with this finding have been reported to develop CIN2 or worse (28). This substantiates the use of atypical squamous cells suggesting HSIL as a surrogate of progression, as in the present study (CIN/SIL group).…”

Section: Discussionmentioning

confidence: 96%

Human papillomavirus and predictors of cervical intraepithelial neoplasia among young mothers in a prospective follow-up study

Louvanto

Syrjänen

Rintala³

et al. 2010

Acta Obstetricia Et Gynecologica Scandinavica

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Section: Discussionmentioning

confidence: 96%

Human papillomavirus and predictors of cervical intraepithelial neoplasia among young mothers in a prospective follow-up study

Louvanto

Syrjänen

Rintala³

et al. 2010

Acta Obstetricia Et Gynecologica Scandinavica

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“…However, this should be considered cautiously as there is a low inter-observer agreement for interpreting ASC-H smears due to lax diagnostic criteria. Therefore, it is no surprise that prevalence rates of underlying significant histopathology of the cervix among women with smears suggesting ASC-H reported in the literature vary widely from 10% to 80% (McHale et al, 2007;You et al, 2010;Nogara et al, 2011;Kietpeerakool et al, 2009;Cetiner et al, 2013;Kietpeerakool et al, 2008;Bandyopadhyay et al, 2008;Sung et al, 2011;Lee et al, 2006;Cytryn et al, 2009;Selvaggi, 2013). Smears suggesting ASC-H are extremely rare with a reported rate of less than0.5% of all interpretations (You et al, 2010;Cetiner et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Histopathology of Women with “Atypical Squamous Cells Cannot Exclude High-Grade Squamous Intraepithelial Lesion” (ASC-H) Smears

Ratree

Kleebkaow

Aue-aungkul

et al. 2019

Asian Pac J Cancer Prev

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Objectives:To evaluate prevalence of underlying significant pathologies among women with cervical smears rated as ‘atypical squamous cells cannot exclude high grade squamous intraepithelial lesion (ASC-H)’, as well as associated risk factors.Methods:Medical records were reviewed of all consecutive women with ASC-H smears who had undergone colposcopy at Srinagarind Hospital from January 2008 to July 2016. Significant pathology results included cervical intraepithelial neoplasia (CIN) 2-3, adenocarcinoma in situ (AIS), endometrial hyperplasia, and cancer of any original site.Result:During the study period, 133 women with ASC-H were reviewed. The mean age was 45.3 years (range 21-72). The histopathologic results for the 133 women were as follows: no lesions (58; 43.6%), CIN 1 (34; 25.6%), CIN 2-3 (33; 24.8%), AIS (2; 1.5%), and cervical cancer (6; 4.5%). The overall rate of significant pathology was 30.8% (95% confidence interval, 22.9%-38.8%). Women younger than 40 years old carried a higher risk of harboring significant lesions when compared to older women (41.7% versus 27.8%, respectively). There was no significant impact of parity and menopausal status on the risk of significant pathology results.Conclusion:The rate of significant histopathologies among women with ASC-H smears in this study was approximately 31% and the associated risk factor was patient age.

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“…Previous studies have shown that ASC-H is associated with a higher incidence of high-grade histological lesions than ASC-US [2,3,4]. The aim of the present study is to review the cases of ASC-H diagnosed at a single institution and discuss the clinical management in these cases.…”

Section: Introductionmentioning

confidence: 99%

“…There is a long latency period between a high-risk HPV infection and the occurrence of precancerous and cancerous lesions, and >90% of HPV infections spontaneously clear within 2 years. If the infection persists, viruses could integrate into the human genome and lead to cervical intraepithelial neoplasia and carcinoma in situ [2]. Screening for and detection of pre-invasive disease have turned cervical cancer into a potentially preventable gynecologic malignancy [3].…”

Section: Introductionmentioning

confidence: 99%

Clinical Relevance of ASC-H Cytologies: Experience in a Single Tertiary Hospital

Arco

Montoro²,

D³

et al. 2016

Acta Cytologica

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Objectives: To review the cases of atypical squamous cells (ASC), cannot exclude squamous intraepithelial lesion (ASC-H) diagnosed at a single institution and to discuss the interpretation challenges and clinical management of these cases. Study Design: The ASC-H cases diagnosed at our institution from 2006 to 2015 were studied retrospectively; of 159,000 Pap smears, there were 959 cases of ASC of undetermined significance (ASC-US) and 148 cases of ASC-H. We have reviewed the clinical records of the ASC-H cases, and data have been analyzed using SPSS 20.0. Results: Median age was 43.1 years; 49.6% of the patients had previous cervical cytologies, and 55.9% of them were negative. Following ASC-H diagnosis, another smear was obtained in 97.1% of the cases and in 67.6% a biopsy was performed. Biopsy revealed low-grade dysplasia in 18.8% of the cases, high-grade dysplasia in 27.8%, and infiltrating carcinoma in 2.3%. Patients with significant lesions in histology were younger than patients with negative results (p = 0.08). A diagnosis of ASC-H/squamous intraepithelial lesion in the repeated cytology had a sensitivity of 74.2%, specificity of 39.6%, positive predictive value of 44.8%, and negative predictive value of 70% for the diagnosis of dysplasia. Conclusions: ASC-H diagnosis is associated with a high incidence of histological high-grade lesions. A repeat cytology can aid in the selection of high-risk patients, but there may be false-negative results.

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The risk of CIN II or greater in a one-year follow-up period in patients with ASC-H interpreted with cytology

Cited by 7 publications

References 22 publications

Human papillomavirus and predictors of cervical intraepithelial neoplasia among young mothers in a prospective follow-up study

Human papillomavirus and predictors of cervical intraepithelial neoplasia among young mothers in a prospective follow-up study

Histopathology of Women with “Atypical Squamous Cells Cannot Exclude High-Grade Squamous Intraepithelial Lesion” (ASC-H) Smears

Clinical Relevance of ASC-H Cytologies: Experience in a Single Tertiary Hospital

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