Outcomes and Management of Atypical Squamous Cells--Cannot Exclude High-Grade Squamous Intraepithelial Lesion in a Primary Human Papillomavirus Screening System.
Context.--"Atypical squamous cells--cannot exclude high-grade squamous intraepithelial lesion" (ASC-H) cytology is uncommon (0.16%--0.43%). The reported risk of high-grade dysplasia varies greatly (12.00%--70.00%), making management challenging. Primary human papillomavirus (HPV) screening requires...
| Publicado en: | Archives of Pathology & Laboratory Medicine Vol. 149; no. 11; pp. 1022 - 1027 |
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| Autores principales: | , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
College of American Pathologists
Nov2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=189527473&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 189527473 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00039985 1FS jtl: Archives of Pathology & Laboratory Medicine issn: 00039985 maglogo: N pubinfo: dt: Nov2025 vid: 149 iid: 11 pid: 2550 pub: College of American Pathologists place: Northfield, Illinois artinfo: ui: 189527473 189527473 189527473 10.5858/arpa.2024-0423-OA 189527473 ppf: 1022 ppct: 5 formats: fmt: @attributes: type: P tig: atl: Outcomes and Management of Atypical Squamous Cells--Cannot Exclude High-Grade Squamous Intraepithelial Lesion in a Primary Human Papillomavirus Screening System. aug: au: Cheung, Maria A. McKeown, Ciaran D. McCarthy, Claire M. affil: Department of Colposcopy, Rotunda Hospital, Dublin, Ireland sug: subj: Cervix Pathology Cancer Screening Papillomavirus Infections Diagnosis Human Papillomavirus Viruses Analysis Cervical Intraepithelial Neoplasia Physiopathology Cervical Intraepithelial Neoplasia Diagnosis Cervix Dysplasia Physiopathology Cervix Dysplasia Diagnosis Cervix Dysplasia Therapy Cervical Intraepithelial Neoplasia Therapy Treatment Outcomes Evaluation Colposcopy Referral and Consultation Counseling Human Female Diagnosis, Laboratory Early Detection of Cancer Ireland Retrospective Design Record Review Sensitivity and Specificity Predictive Value of Tests Risk Assessment Cervical Intraepithelial Neoplasia Surgery Adenocarcinoma Physiopathology Cytology Cross Sectional Studies Adult Polymerase Chain Reaction Biopsy Documentation Descriptive Statistics Data Analysis Software Cervical Intraepithelial Neoplasia Classification Electrosurgery Ablation Techniques Conservative Treatment Histological Techniques Cervical Intraepithelial Neoplasia Risk Factors Adult: 19-44 years Female ab: Context.--"Atypical squamous cells--cannot exclude high-grade squamous intraepithelial lesion" (ASC-H) cytology is uncommon (0.16%--0.43%). The reported risk of high-grade dysplasia varies greatly (12.00%--70.00%), making management challenging. Primary human papillomavirus (HPV) screening requires an updated understanding of ASC-H. Objective.--To review ASC-H colposcopic and histologic comparators, and management outcomes, to help guide future management. Design.--A 1-year retrospective analysis of new ASC-H-- associated visits to a large colposcopy unit in Ireland in 2022 was performed. Results.--The incidence of new ASC-H referrals was 3.63% (97 of 2672). The sensitivity of colposcopy for detection of high-grade changes (cervical intraepithelial neoplasia [CIN]21) is 69.39% (34 of 49) and the specificity is 43.18% (19 of 44). The positive predictive value is 64.15% (34 of 53) and the negative predictive value is 37.50% (15 of 40). High-grade dysplasia was identified in 53.26% (49 of 92) and adenocarcinoma in situ in 2.17% (2 of 92) of cases. Excisional treatment was performed for 52.58% (51 of 97) and cold coagulation for 12.37% (12 of 97) of cases. The test-of-cure result was HPV negative for 84.13%. High-risk HPV and abnormal cytology was seen in 9.52% (6 of 63) of cases, thus all required a second test-of-cure smear. Conclusions.--ASC-H with high-risk HPV has a 55.43% (51 of 92) risk of high-grade dysplasia, thus timely colposcopy and biopsy is imperative. Treatment was curative in 84.13% (53 of 63) to 96.83% (61 of 63) of cases, so it is an effective management strategy. Conservative management of selected cases may be a reasonable option. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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