ASCCP Practice Guidelines Management Guidelines for the Follow-up of Cytology Read as Low Grade Squamous Intraepithelial Lesion

2000 ◽  
Vol 4 (2) ◽  
pp. 83-92 ◽  
Author(s):  
J. Thomas Cox ◽  
L. Stewart Massad ◽  
Neil Lonky ◽  
Robert Tosh ◽  
Alan Waxman ◽  
...  
Keyword(s):  
Practice Guidelines ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Management Guidelines ◽  
Intraepithelial Lesion

scholarly journals Negative Loop Electrosurgical Cone Biopsy Finding Following a Biopsy Diagnosis of High-Grade Squamous Intraepithelial Lesion: Frequency and Clinical Significance

2012 ◽  
Vol 136 (10) ◽  
pp. 1259-1261 ◽  
Author(s):  
Benjamin L. Witt ◽  
Rachel E. Factor ◽  
Elke A. Jarboe ◽  
Lester J. Layfield
Keyword(s):  
Clinical Significance ◽  
Low Grade ◽  
High Grade ◽  
Biopsy Finding ◽  
Squamous Intraepithelial Lesion ◽  
Positive Biopsy ◽  
Biopsy Diagnosis ◽  
Negative Findings ◽  
Intraepithelial Lesion

Context.—Loop electrosurgical excision procedure (LEEP) is a therapeutic option following biopsy diagnosis of high-grade squamous intraepithelial lesion (HSIL). Most LEEPs will confirm the HSIL biopsy diagnosis but a number of them will not. Such negative findings suggest the possibility of an incorrect biopsy diagnosis, removal of the lesion by biopsy, or insufficient LEEP sampling. Objective.—To determine the frequency of negative LEEP findings following HSIL biopsies and better understand the clinical significance of negative LEEP findings. Design.—The Department of Pathology's records were searched for all patients undergoing LEEP excision who had prior cervical biopsies and subsequent clinical follow-up. Results.—Three hundred seventy-eight women were found who had index biopsies, subsequent LEEPs, and clinical follow-up averaging 25.8 months. Three hundred six women had HSIL on biopsy with 223 (73%) showing HSIL on LEEP. Seventy-three (24%) LEEPs in women with HSIL index biopsy results yielded negative findings or disclosed low-grade squamous intraepithelial lesion (LSIL). Twenty-nine of 223 patients (13%) with an HSIL result both on biopsies and LEEPs had HSIL on biopsy and/or excisional clinical follow-up. Seven of 73 patients (10%) with positive (HSIL) biopsy results but negative LEEP findings or LSIL had HSIL on biopsy and/or excisional follow-up. Conclusions.—Twenty-four percent of patients with HSIL on biopsy had negative findings or LSIL on LEEP. There is no statistical difference in development of HSIL after LEEP for those with positive biopsy and positive LEEP results (13%) versus positive biopsy and negative LEEP results (10%). The occurrence of a negative LEEP finding following a positive biopsy finding was frequent (24%) and does not portend a different clinical follow-up from a positive biopsy and positive LEEP result.

scholarly journals Evaluation of the In Situ Hybridization Signal Patterns of Liquid-Based Cytological Human Papillomavirus Specimens for Diagnosing Squamous Intraepithelial Lesion

2011 ◽  
Vol 2011 ◽  
pp. 1-9
Author(s):  
Katsunari Ishida ◽  
Makoto Nagasaki ◽  
Masayuki Kobayashi ◽  
Tatsushi Nakagawa ◽  
Toru Nabika ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Routine Testing ◽  
Squamous Cells ◽  
Intraepithelial Lesion ◽  
Liquid Based Cytology ◽  
Undetermined Significance

To examine the diagnostic utility for squamous intraepithelial lesion (SIL) by cytological in situ hybridization (c-ISH) for the human papillomavirus using liquid-based cytology specimens, we investigated c-ISH signal patterns in the cases of low-grade SIL (LSIL), atypical squamous cells of undetermined significance (ASC-US), and high-grade SIL (HSIL). Episomal (E) and/or integrated (I) signals were observed. Two signal patterns (E≧I or I>E) were obtained by counting the number of E+ or I+ cells. E≧I was specific to LSIL and ASC-US (10/12); I>E, to HSIL (9/11) (P<0.01, χ2 test), suggesting significant utility of c-ISH in diagnosing SIL. In the cell fraction, E≧I in large cells was dominant in LSIL. Two cases of I>E in large cells of LSIL showed HPV persistence and/or progression during follow-up. Thus, c-ISH is useful in routine testing for diagnosing cervical dysplastic lesions, especially for detecting LSIL suspected for progression.

scholarly journals Prevalence of high-grade squamous intraepithelial lesions and cervical cancer among patients with unsatisfactory colposcopic examination, without visible lesion

2009 ◽  
Vol 127 (5) ◽  
pp. 266-269 ◽  
Author(s):  
Fernanda Rangel da Veiga ◽  
Fábio Bastos Russomano ◽  
Maria José de Camargo ◽  
Aparecida Cristina Sampaio Monteiro ◽  
Aparecida Tristão ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Public Health Problem ◽  
Cervical Canal ◽  
Clinical Approach ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cross Sectional ◽  
Intraepithelial Lesion

CONTEXT AND OBJECTIVE: Cervical cancer is a serious public health problem in Brazil. For patients with unsatisfactory colposcopic examinations without visible lesions, but with cervical cytological tests suggesting high-grade squamous intraepithelial lesion (HSIL), the national recommendation is to repeat cervical cytological tests after three months. Our aim was to assess the prevalence of HSIL and cancer among patients with initial cervical cytological tests suggestive of HSIL but with unsatisfactory colposcopic examinations without visible lesions, in order to contribute towards the discussion regarding a more effective clinical approach that might diminish the likelihood of patient abandonment of follow-up before appropriate diagnosis and treatment. DESIGN AND SETTING: Cross-sectional study in Colposcopy Clinic of IFF/Fiocruz. METHOD: Patients admitted between December 1989 and April 2007 with cytological diagnoses of HSIL but with unsatisfactory colposcopic examinations without visible lesions underwent cervical cone biopsy. RESULTS: Sixty-five such patients were included, comprising 33.8% with HSIL and 4.6% with cancer, confirmed histologically. The other patients presented low-grade squamous intraepithelial lesion (26.1%), glandular dysplasia (1.5%) and absence of disease (33.8%). CONCLUSION: The observed prevalence of cancer and HSIL does not seem to be enough to justify immediate referral for cone biopsies to investigate the cervical canal in these cases. The findings suggest that the recommendation of repeated cytological tests following an initial one with HSIL, among patients with unsatisfactory colposcopic examinations without visible lesions, is appropriate in our setting. Efforts are needed to ensure adherence to follow-up protocols in order to reduce the chances of losses.

Adjunctive Human Papillomavirus Testing in the 2-Year Follow-up of Women With Low-Grade Cervical Cytologic Abnormalities: A Randomized Trial and Economic Evaluation

2003 ◽  
Vol 127 (9) ◽  
pp. 1169-1175 ◽  
Author(s):  
Alice Lytwyn ◽  
John W. Sellors ◽  
James B. Mahony ◽  
Dean Daya ◽  
William Chapman ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Cervical Intraepithelial Neoplasia ◽  
Pap Test ◽  
Intraepithelial Neoplasia ◽  
Low Grade ◽  
High Grade ◽  
Hpv Testing ◽  
Squamous Intraepithelial Lesion ◽  
Intraepithelial Lesion

Abstract Context.—Although human papillomavirus (HPV) testing may aid in managing low-grade abnormality on screening cervical cytology, patient compliance with repeat testing programs requires consideration. Objectives.—To determine effectiveness and costs of repeated Papanicolaou (Pap) test and oncogenic HPV testing for detecting cervical intraepithelial neoplasia 2 or 3. Design.—We conducted a randomized controlled trial of combined Pap test and cervical HPV testing by Hybrid Capture 1 test compared with Pap test alone; tests were performed every 6 months for up to 2 years. The study end point was colposcopic examination performed on all women at 2 years, or earlier if an HPV test was positive or if a Pap test showed high-grade squamous intraepithelial lesion. Setting.—Sixty-six community family practices. Participants.—Two hundred fifty-seven women with atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion on screening cervical cytology. Main Outcome Measures.—Detection of histologically confirmed cervical intraepithelial neoplasia 2 or 3, fully allocated costs, and loss to follow-up. Results.—Combined Pap test and HPV testing detected 11 (100%) of 11 cases of cervical intraepithelial neoplasia 2/3, whereas Pap test alone detected 7 (63.6%) of these 11 cases (P = .14); corresponding specificities were 39 (46.4%) of 84 and 45 (71.4%) of 63 (P = .005). The cost-effectiveness ratio was Can $4456 per additional case of high-grade cervical intraepithelial neoplasia. Sixty-nine (26.8%) of the 257 women (24.6% combined group vs 29.1% Pap test only group, P = .41) defaulted from testing or from colposcopy when referred with an abnormal result. Conclusions.—Combined testing was more costly but may detect more cases of cervical intraepithelial neoplasia 2/3 than Pap test alone. However, poor adherence limits usefulness of a management strategy that requires repeated follow-up.

Follow up in women with biopsy diagnosis of cervical low-grade squamous intraepithelial lesion (LSIL): how long should it be?

2017 ◽  
Vol 295 (4) ◽  
pp. 997-1003 ◽  
Author(s):  
Andrea Ciavattini ◽  
Nicolò Clemente ◽  
Dimitrios Tsiroglou ◽  
Francesco Sopracordevole ◽  
Matteo Serri ◽  
...  
Keyword(s):  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Biopsy Diagnosis ◽  
Intraepithelial Lesion

scholarly journals Correlation of Histopathologic Follow-up Findings With Vaginal Human Papillomavirus and Low-Grade Squamous Intraepithelial Lesion Papanicolaou Test Results

2011 ◽  
Vol 135 (12) ◽  
pp. 1545-1549 ◽  
Author(s):  
Mona Bansal ◽  
R Marshall Austin ◽  
Chengquan Zhao
Keyword(s):  
Human Papillomavirus ◽  
Low Grade ◽  
Hpv Testing ◽  
Test Results ◽  
Squamous Intraepithelial Lesion ◽  
Papanicolaou Test ◽  
Dna Test ◽  
Correlation Data ◽  
Intraepithelial Lesion

Context.—Data on high-risk human papillomavirus (hrHPV) DNA test results in vaginal, liquid-based cytology (LBC) specimens and corresponding cytologic and histopathologic correlation data are limited. Objective.—To analyze follow-up correlation data associated with vaginal (after hysterectomy) low-grade squamous intraepithelial lesion (LSIL) LBC and hrHPV test results. Design.—Hospital records were searched for vaginal LSIL LBC and hrHPV results between July 1, 2005, and July 30, 2009. Histopathologic and Papanicolaou test follow-up correlation data were analyzed. Results.—During the study period, 2892 patients with test results from both posthysterectomy vaginal LBC and hrHPV were identified: 148 (5.1%) of the patients had vaginal Papanicolaou test results reported as LSIL, with hrHPV detected in 113 of the 148 patients (76.4%). Of 148 patients, 59 of those with vaginal LSIL including 48 (81.4%) with positive HPV testing and 11 (18.6%) with negative HPV testing results had a follow-up vaginal biopsy. Histopathologic vaginal intraepithelial neoplasia (VAIN) 2/3 was diagnosed in 7 of 59 patients (11.9%) with biopsies. In all 7 patients who were diagnosed with VAIN 2/3, hrHPV was detected in the LBC vial. No VAIN 2/3 diagnoses were documented in the biopsy specimens from the 11 patients with hrHPV− LSIL Papanicolaou test results. Histopathologic VAIN 2/3 was diagnosed from vaginal biopsies in 7 of the 48 patients (14.6%) with vaginal hrHPV+ LSIL test results. Conclusions.—Sensitivity and specificity of hrHPV test results associated with histopathologic follow-up diagnoses of VAIN 2/3 in patients with vaginal LSIL results were 100% and 21.2%, respectively. The positive predictive value of a vaginal hrHPV+ LSIL result for a subsequent histopathologic VAIN 2/3 diagnosis was 14.6%. No cases of VAIN 2/3 were diagnosed in the 11 patients with vaginal hrHPV− LSIL results. Correlations of vaginal cytologic, histopathologic, and human papillomavirus findings were quite similar to correlation findings previously reported in older women with cervical LSIL test results.

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