scholarly journals Assessment of cytologic follow-up as the recommended management for patients with atypical squamous cells of undetermined significance or low grade squamous intraepithelial lesions

Cancer ◽  
1998 ◽  
Vol 84 (1) ◽  
pp. 5-10 ◽  
Author(s):  
Ken W. Alanen ◽  
Laurie M. Elit ◽  
Patricia A. Molinaro ◽  
Catherine M. McLachlin
Keyword(s):  
Low Grade ◽  
Squamous Intraepithelial Lesions ◽  
Squamous Cells ◽  
Intraepithelial Lesions ◽  
Undetermined Significance

scholarly journals Follow-up of women with atypical squamous cells cannot exclude high-grade squamous intraepithelial lesions (ASC-H)

2014 ◽  
Vol 132 (1) ◽  
pp. 15-22 ◽  
Author(s):  
Fanny Lopez-Alegria ◽  
Dino Soares De Lorenzi ◽  
Orlando Poblete Quezada
Keyword(s):  
Primary Healthcare ◽  
Lesion Detection ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesions ◽  
Squamous Cells ◽  
The Times ◽  
Primary Healthcare Clinics ◽  
Intraepithelial Lesions

CONTEXT AND OBJECTIVE: The concept that the presence of atypical squamous cells cannot exclude high-grade squamous intraepithelial lesions (ASC-H) was introduced in the 2001 Bethesda System of cervical cytology classification. This nomenclature defines cervical cancer precursor lesions. The objective of this study was to investigate the colpocytological-histological results from a three-year follow-up conducted on a cohort of women with reports of ASC-H who were attended during 2005-2006 at clinics of the Southern Metropolitan Healthcare Service of Santiago, Chile. DESIGN AND SETTING: Prospective cohort study at primary healthcare clinics in Santiago, Chile. METHODS : Colpocytological-histological follow-up was conducted over a three-year period on 92 women with cytological reports of ASC-H who were attended at primary healthcare clinics during 2005-2006. RESULTS : At the end of the follow-up period, high-grade lesions were evaluated and the following outcomes were observed: seven women presented invasive cancer (7.6%), 49 presented high-grade lesions (53.3%), 26 presented low-grade lesions (28.2%) and 10 presented normal results (10.9%). The "Conditional Probabilities Tree Diagram" was used to show the results from tests and the times of lesion detection. It demonstrated that, after a first report of ASC-H, clinical management needed to be interventionist. CONCLUSION: The follow-up on our cohort of women showed that the majority of uncertain ASC-H diagnoses (82.6%) had abnormal colposcopic results and that during the follow-up using ASC-H smears, two out of every three women developed high-grade lesions.

Whole-Slide Imaging of Pap Cellblock Preparations Is a Potentially Valid Screening Method

2015 ◽  
Vol 59 (2) ◽  
pp. 187-200 ◽  
Author(s):  
Ossama Tawfik ◽  
Marilyn Davis ◽  
Susan Dillon ◽  
Laila Tawfik ◽  
Francisco J. Diaz ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Low Grade ◽  
Adenocarcinoma In Situ ◽  
High Grade ◽  
Whole Slide Imaging ◽  
Squamous Intraepithelial Lesions ◽  
Squamous Cells ◽  
The Impact ◽  
Intraepithelial Lesions ◽  
Undetermined Significance

Objective: To date, the impact of digital imaging on routine cytology remains far from perfect. Cellblock (CB) preparations from Pap samples have been shown to be diagnostically valuable. We evaluated the validity of utilizing whole-slide imaging (WSI) prepared from Pap CBs as a screening tool. Study Design: A total of 1,110 CB slides prepared from residual Pap samples were analyzed - 563 normal, 282 atypical squamous cells of undetermined significance (ASCUS), 12 atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion, 188 low-grade squamous intraepithelial lesions (LSIL), 36 high-grade squamous intraepithelial lesions (HSIL), 25 atypical glandular cells of undetermined significance, 1 adenocarcinoma in situ, 2 invasive adenocarcinomas, and 1 squamous cell carcinoma. Virtual slides were obtained using the Aperio system. Test performance characteristics of liquid-based samples and WSI from CB samples were compared. Results: Average sensitivity and specificity of the five WSI reviewers was 58.3 and 85.1% for ASCUS, respectively, 54.1 and 93.9% for LSIL, and 51.8 and 98.8% for HSIL. Overall WSI sensitivity and specificity for detecting lesions was 82.1 and 86.2%, respectively. Agreement (kappa values) between WSI reviewers was 0.56 for ASCUS, 0.69 for LSIL, 0.67 for HSIL, and 0.74 for negative samples. Conclusions: WSI of CB preparations is a feasible method to achieve high-quality specimen preparations. It is as sensitive as liquid-based methods and appears to be highly specific for the detection of LSIL and HSIL.

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