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Journal of Lower Genital Tract Disease:
doi: 10.1097/01.lgt.0000245039.45094.9a
Original Articles

Is Atypical Squamous Cells That Cannot Exclude High-grade Squamous Intraepithelial Lesion Clinically Significant?

McHale, Michael T. MD1; Souther, Jessica MD1; Elkas, John C. MD, JD2; Monk, Bradley J. MD3; Harrison, Terry A. MD1

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Objective. To determine the cumulative risk of cervical intraepithelial neoplasia (CIN) 2 or 3 in patients with atypical squamous cells, cannot exclude HSIL (ASC-H).

Methods. A retrospective analysis was performed to identify patients referred to the dysplasia clinic with ASC-H. Initial evaluation included colposcopy, endocervical curettage, and an ectocervical biopsy, when indicated, in all the patients. A follow-up evaluation was performed at 6 and 12 months. Cumulative histological diagnosis of CIN 2 or 3 at 12 months served as the clinical end point.

Results. Two hundred twenty-nine patients with ASC-H and with a mean age of 32.8 years were evaluated. At the time of initial colposcopy, only 10.0% (23/229; 95% CI = 6.5%-15%) of the patients had histological evidence of CIN 2 or 3. The cumulative risk of CIN 2 or 3 was 12.2% (95% CI = 8%-17%).

Conclusions. Evaluation of patients with ASC-H with colposcopy does lead to the detection of CIN 2 or 3 but perhaps at a rate lower than previously reported.

©2007The American Society for Colposcopy and Cervical Pathology


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