Evaluation of Low-Grade Squamous Intraepithelial Lesions, Cannot Exclude High-Grade Squamous Intraepithelial Lesions on Cervical Smear
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Background : We examined cervicovaginal smears that contained definite low-grade squamous intraepithelial lesion (LSIL) cells and rare atypical cells suggestive of high-grade SIL (HSIL) (ASC-H) or contained borderline dysplastic cells between LSIL and HSIL. Such lesions were classified as LSIL-H. This study aimed to investigate the cytologic and histologic characteristics of LSIL-H category and we evaluated the associated clinical risk. Methods : The histologic outcomes of LSIL-H were compared with those of LSIL and ASC-H. Both the cytologic and histologic findings of LSIL-H that were confirmed as cervical intraepithelial neoplasia 2 (CIN2) or greater (CIN2+) were investigated. Results : LSIL-H accounted for 0.09% of the Pap tests. On the follow-up histology, the most frequent outcome was CIN2, and the risk of CIN2+ was higher than that for ASC-H. In the cases of LSIL-H that was histologically confirmed as CIN2+, most of the atypical cells suggestive of HSIL were cytologically similar to those of CIN2, and the corresponding cervical tissues were characterized by small CIN2+ lesions in a large background of flat condyloma/CIN1. The LSIL-H cases not confirmed on initial colposcopically-directed biopsy required further follow-up. Conclusions : LSIL-H may be a valid diagnostic category with distinctive features that are different from LSIL or ASC-H. LSIL-H needs further follow-up for the proper management.
Abstract
Background : We examined cervicovaginal smears that contained definite low-grade squamous intraepithelial lesion (LSIL) cells and rare atypical cells suggestive of high-grade SIL (HSIL) (ASC-H) or contained borderline dysplastic cells between LSIL and HSIL. Such lesions were classified as LSIL-H. This study aimed to investigate the cytologic and histologic characteristics of LSIL-H category and we evaluated the associated clinical risk. Methods : The histologic outcomes of LSIL-H were compared with those of LSIL and ASC-H. Both the cytologic and histologic findings of LSIL-H that were confirmed as cervical intraepithelial neoplasia 2 (CIN2) or greater (CIN2+) were investigated. Results : LSIL-H accounted for 0.09% of the Pap tests. On the follow-up histology, the most frequent outcome was CIN2, and the risk of CIN2+ was higher than that for ASC-H. In the cases of LSIL-H that was histologically confirmed as CIN2+, most of the atypical cells suggestive of HSIL were cytologically similar to those of CIN2, and the corresponding cervical tissues were characterized by small CIN2+ lesions in a large background of flat condyloma/CIN1. The LSIL-H cases not confirmed on initial colposcopically-directed biopsy required further follow-up. Conclusions : LSIL-H may be a valid diagnostic category with distinctive features that are different from LSIL or ASC-H. LSIL-H needs further follow-up for the proper management.
참고문헌 (11)
- Solomon D, "The 2001 Bethesda System:terminology for reporting results of cervical cytology", JAMA, 287, pp.2114~2119 (2002)
- Solomon D, "The Bethesda System for reporting cervical cytology: definitions, criteria, and explanatory notes. 2nd ed" (2004), Springer
- Woodhouse SL, "Interobserver variability in subclassification of squamous intraepithelial lesions:results of the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology", Arch Pathol Lab Med, 123, pp.1079~1084 (1999)
- McGrath CM, "Evaluation of mild-to-moderate dysplasia on cervical-endocervical(Pap)smear:a subgroup of patients who bridge LSIL and HSIL", Diagn Cytopathol, 23, pp.245~248 (2000)
- Nasser SM, "The significance of the Papanicolaou smear diagnosis of low-grade squamous intraepithelial lesion cannot exclude high-grade squamous intraepithelial lesion", Cancer, 99, pp.272~276 (2003)
- Elsheikh TM, "The significance of"low-grade squamous intraepithelial lesion,cannot exclude high-grade squamous intraepithelial lesion"as a distinct squamous abnormality category in Papanicolaou tests", Cancer, 108, pp.277~281 (2006)
- Owens CL, ""Low-grade squamous intraepithelial lesion,cannot exclude high-grade squamous intraepithelial lesion"is a distinct cytologic category:histologic outcomes and HPV prevalence", Am J Clin Pathol, 128, pp.398~403 (2007)
- Kir G, "LSIL with ASC-H” on cervicovaginal smears: is it a valid category to predict cases with HSIL follow-up?", Eur J Gynaecol Oncol, 25, pp.462~464 (2004)
- Shidham VB, "Should LSIL with ASC-H(LSIL-H)in cervical smears be an independent category? A study on SurePath specimens with review of literature", Cytojournal, 4, pp.7~ (2007)
- Alsharif M, "Clinical significance of the diagnosis of low-grade squamous intraepithelial lesion,cannot exclude high-grade squamous intraepithelial lesion", Cancer Cytopathol, 117, pp.92~100 (2009)
- Jones BA, "Cervical biopsy-cytology correlation:a College of American Pathologists Q-Probes study of 22 439 correlations in 348 laboratories", Arch Pathol Lab Med, 120, pp.523~531 (1996)