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Hata H, Okayama K, Iijima J, Teruya K, Shiina N, Caniz T, Ishii Y, Fujii M, Oda M, Okodo M. A Comparison of Cytomorphological Features of ASC-H Cells Based on Histopathological Results Obtained from a Colposcopic Target Biopsy Immediately after Pap smear Sampling. Asian Pac J Cancer Prev 2019; 20:2139-2143. [PMID: 31350977 PMCID: PMC6745206 DOI: 10.31557/apjcp.2019.20.7.2139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Indexed: 11/25/2022] Open
Abstract
Background: To compare the cytomorphological features of atypical squamous cells, cannot exclude high-grade
squamous intraepithelial lesion (ASC-H) observed in a liquid-based Pap smear with the histopathological features
observed in a concurrent colposcopic biopsy specimen obtained immediately after obtaining the Pap smear. Methods:
Cytomorphological features such as cytoplasmic differentiation, nuclear/cytoplasm (N/C) ratio, chromatin pattern,
thickening of nuclear contour, and the appearance of the nucleolus of 247 ASC-H obtained from 25 liquid-based Pap
smear ASC-H cases were compared with those of the cells obtained from biopsied samples. Human papillomavirus
(HPV) infection was tested for 39 HPV genotypes using Uniplex E6/E7 polymerase chain reaction method. Results:
Of the 25 ASC-H cases, 22 (88%) showed cervical intraepithelial neoplasia grade 1 or greater (CIN1+) and 3 (12%)
were benign. HPV infection was detected in 100% CIN1+ cases and 66.7% benign cases. Significant differences such as
marked hyperchromasia, thickened nuclear contour, and prominent nucleoli were observed between ASC-H cases with
CIN1+ and the benign cases. Conclusion: The presence of small dysplastic cells displaying marked hyperchromasia,
thickening of nuclear contour, and prominent nucleoli on Pap smear strongly suggest the presence of CIN in ASC-H cases.
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Affiliation(s)
- Hiromi Hata
- Department of Medical Technology, Faculty of Health Sciences, Kyorin University, 5-4-1 Shimorenjaku, Mitaka-shi, 181-8621, Tokyo, Japan.
| | - Kaori Okayama
- School of Medical Technology, Faculty of Health Science, Gunma Paz University, 1-7-1 Tonyamachi, Takasaki-shi, 370-0006, Gunma, Japan
| | - Junko Iijima
- Department of Medical Technology, Faculty of Health Sciences, Kyorin University, 5-4-1 Shimorenjaku, Mitaka-shi, 181-8621, Tokyo, Japan.
| | - Koji Teruya
- Department of Health and welfare, Faculty of Health Sciences, Kyorin University, 5-4-1 Shimorenjaku, Mitaka-shi, 181-8621, Tokyo, Japan
| | - Natsuko Shiina
- ILABO Cyto STD Laboratory, Inc., 560-6 Shimoonkata, Hachiouji-shi, 192-0154 Tokyo, Japan
| | - Timothy Caniz
- ILABO Cyto STD Laboratory, Inc., 560-6 Shimoonkata, Hachiouji-shi, 192-0154 Tokyo, Japan
| | - Yasuyoshi Ishii
- Genki Plaza Medical Center for Health Care, 3-6-5 Iidabashi, Chiyoda-ku, 102-0072, Tokyo, Japan
| | - Masahiko Fujii
- Genki Plaza Medical Center for Health Care, 3-6-5 Iidabashi, Chiyoda-ku, 102-0072, Tokyo, Japan
| | - Mizue Oda
- Genki Plaza Medical Center for Health Care, 3-6-5 Iidabashi, Chiyoda-ku, 102-0072, Tokyo, Japan
| | - Mitsuaki Okodo
- Department of Medical Technology, Faculty of Health Sciences, Kyorin University, 5-4-1 Shimorenjaku, Mitaka-shi, 181-8621, Tokyo, Japan.
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Díaz Del Arco C, Sanabria Montoro MC, García López D, Rodríguez Escudero E, Fernández Aceñero MJ. Clinical Relevance of ASC-H Cytologies: Experience in a Single Tertiary Hospital. Acta Cytol 2016; 60:217-24. [PMID: 27490700 DOI: 10.1159/000448022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 06/27/2016] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To review the cases of atypical squamous cells (ASC), cannot exclude squamous intraepithelial lesion (ASC-H) diagnosed at a single institution and to discuss the interpretation challenges and clinical management of these cases. STUDY DESIGN The ASC-H cases diagnosed at our institution from 2006 to 2015 were studied retrospectively; of 159,000 Pap smears, there were 959 cases of ASC of undetermined significance (ASC-US) and 148 cases of ASC-H. We have reviewed the clinical records of the ASC-H cases, and data have been analyzed using SPSS 20.0. RESULTS Median age was 43.1 years; 49.6% of the patients had previous cervical cytologies, and 55.9% of them were negative. Following ASC-H diagnosis, another smear was obtained in 97.1% of the cases and in 67.6% a biopsy was performed. Biopsy revealed low-grade dysplasia in 18.8% of the cases, high-grade dysplasia in 27.8%, and infiltrating carcinoma in 2.3%. Patients with significant lesions in histology were younger than patients with negative results (p = 0.08). A diagnosis of ASC-H/squamous intraepithelial lesion in the repeated cytology had a sensitivity of 74.2%, specificity of 39.6%, positive predictive value of 44.8%, and negative predictive value of 70% for the diagnosis of dysplasia. CONCLUSIONS ASC-H diagnosis is associated with a high incidence of histological high-grade lesions. A repeat cytology can aid in the selection of high-risk patients, but there may be false-negative results.
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