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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

Journal of Lower Genital Tract Disease: April 2007 - Volume 11 - Issue 2 - p 86-89
doi: 10.1097/01.lgt.0000245039.45094.9a
Original Articles
Spanish Translation

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.

Atypical squamous cells of undetermined significance, cannot exclude HSIL, may be associated with a rate of cervical intraepithelial neoplasia lower than what was previously reported.

1Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Naval Medical Center San Diego, San Diego, CA, 2Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Walter Reed Army Medical Center, Washington, DC, 3Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of California, Irvine, CA

Reprint requests to: Michael T. McHale, MD, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Naval Medical Center San Diego, 34730 Bob Wilson Dr, San Diego, CA 92134. E-mail: mtmchale@nmcsd.med.navy.mil

©2007The American Society for Colposcopy and Cervical Pathology