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Triage of women with ASCUS and LSIL cytology
Author(s) -
Wentzensen Nicolas,
Bergeron Christine,
Cas Frederic,
Vinokurova Svetlana,
von Knebel Doeberitz Magnus
Publication year - 2006
Publication title -
cancer cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.22420
Subject(s) - ascus (bryozoa) , medicine , colposcopy , papanicolaou stain , cytology , squamous intraepithelial lesion , triage , concordance , biopsy , gynecology , cancer , cervical cancer , pathology , cervical intraepithelial neoplasia , emergency medicine , botany , ascospore , spore , biology
BACKGROUND. The identification of a small percentage of high‐grade cervical intraepithelial neoplasias (HGCIN) among patients with minor cytological abnormalities (atypical squamous cells of undetermined significance [ASCUS] and/or low‐grade squamous intraepithelial lesions [LSIL] group) is a major problem in cytology‐based cervical cancer screening. The authors investigated the efficacy of p16 INK4a as a biomarker to identify samples of patients with HGCIN among those with an ASCUS or LSIL result in Papanicolaou cytology. METHODS. Consecutive liquid‐based cytology specimens of 137 ASCUS and 88 LSIL results were selected from gynecologists who adopted a triage regimen with biopsy under colposcopy 2 months later, independent of the p16 INK4a result. p16 INK4a stained slides were prepared and independently read by 2 observers, who used a recently described score to categorize p16 INK4a stained squamous cells. The endpoint of the study was detection of a biopsy‐confirmed HGCIN. RESULTS. The overall sensitivity and specificity of p16 INK4a positive cells with a nuclear score >2 for diagnosis of HGCIN in ASCUS and LSIL cases combined was 96% and 83%, respectively. The sensitivity and specificity in the ASCUS group was 95% and 84%, and 100% and 81% in the LSIL group, respectively. Two observers had a high concordance in assessing p16 INK4a stained cells (κ value of 0.841). CONCLUSIONS. These data suggested that the use of p16 INK4a as a biomarker combined with nuclear scoring of p16 INK4a positive cells in cervical cytology to triage ASCUS and/or LSIL cases allows identification of HGCIN with good sensitivity and specificity. Cancer (Cancer Cytopathol) 2007. © 2006 American Cancer Society.