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Underlying pathology of women with “atypical squamous cells, cannot exclude high‐grade squamous intraepithelial lesion” smears, in a region with a high incidence of cervical cancer
Author(s) -
Kietpeerakool Chumnan,
Srisomboon Jatupol,
Tantipalakorn Charuwan,
Suprasert Prapaporn,
Khunamornpong Surapan,
Nimmanhaeminda Kanchana,
Siriaunkgul Sumalee
Publication year - 2008
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/j.1447-0756.2008.00758.x
Subject(s) - medicine , squamous intraepithelial lesion , colposcopy , incidence (geometry) , koilocyte , histopathology , cervical intraepithelial neoplasia , cytology , cervical cancer , lesion , gynecology , pathology , cancer , physics , optics
Aim: To evaluate the histopathology of women who had “atypical squamous cells, cannot exclude high‐grade squamous intraepithelial lesions” (ASC‐H) on cervical cytology in a region with high incidence of cervical cancer. Methods: This study was conducted at Chiang Mai University Hospital, Chiang Mai, Thailand. All women with ASC‐H, who had undergone colposcopic and histolopathologic evaluation between October 2004 and January 2007, were recruited. Similar cohorts with other squamous cell abnormalities on a Pap‐smear, who had undergone colposcopy during the same period, were included as comparative groups. Results: During the study period, 85 women who had ASC‐H smears underwent colposcopic and histopathologic evaluation. The mean age was 45.3 years (range, 20–64 years). The histopathologic results of these 85 women were as follows: cervical intraepithelial neoplasia (CIN) II‐III, 52 (61.2%); invasive cancer, 7 (8.2%); CIN I, 6 (7.1%); and no lesions, 20 (23.5%). The incidence of underlying CIN II or higher in an ASC‐H smear (69.4%) was intermediate between atypical squamous cell of undetermined significance (22.7%), low‐grade squamous intraepithelial lesion (44.7%) and high‐grade squamous intraepithelial lesion (90.5%) smears. There was no statistically significant difference in the incidence of CIN II or higher between women who were 40 years old or more and those who were younger (68.7% and 71.4%, respectively, P = 0.81), or between pre‐menopausal and post‐menopausal women (71.4% and 63.6%, respectively, P = 0.49). Conclusion: Reporting ASC‐H cytology in our population is strongly associated with significant cervical pathology, particularly invasive cancer that is possibly at a rate higher than previously reported. Women who have ASC‐H smears should therefore be referred for immediate colposcopy regardless of age and menopausal status.