Should the cytologic diagnosis of "atypical squamous cells of undeterminedsignificance" be qualified? An assessment including comparison between conventional and liquid-based technologies

Citation
Rc. Anton et al., Should the cytologic diagnosis of "atypical squamous cells of undeterminedsignificance" be qualified? An assessment including comparison between conventional and liquid-based technologies, CANC CYTOP, 93(2), 2001, pp. 93-99
Citations number
30
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Oncology,"Onconogenesis & Cancer Research
Journal title
CANCER CYTOPATHOLOGY
ISSN journal
0008-543X → ACNP
Volume
93
Issue
2
Year of publication
2001
Pages
93 - 99
Database
ISI
SICI code
0008-543X(20010425)93:2<93:STCDO">2.0.ZU;2-3
Abstract
BACKGROUND. The diagnosis of atypical squamous cells of undetermined signif icance (ASCUS) remains an enigma for the treating physician, because it enc ompasses both benign, reactive, as well as preneoplastic and possibly neopl astic conditions. To address this problem, The Bethesda System recommends q ualifying the ASCUS diagnosis. This study analyzes the difference in the fo llow-up results between the various groups of patients with an ASCUS diagno sis as outlined by the Criteria Committee: favor premalignant (ASCUS-P), fa vor reactive (ASCUS-R), and unqualified (ASCUS-C). The outcome, based on fo llow-up biopsies and/or cytologies, for both the conventional Papanicolaou smear (CS) and liquid-based (LB) methodologies is compared. METHODS. The CS and LB biopsies and/or cytologies included 590 patients and 137 patients, respectively, who had an initial diagnosis of ASCUS. The fin al outcome after subsequent biopsy and cytology within a 1-year period for each methodology was tabulated. Furthermore, the addition of qualifiers for each diagnosis was tabulated for both cytology and biopsy follow-up and co mpared between CS and LB technologies. RESULTS. For CS, 29 patients (8.6%) were found to have squamous intraepithe lial lesions (SIL) on subsequent cytologic smears, and 176 patients (63.7%) had SIL on biopsy follow-up. For LB, these numbers were 17 patients (19.1% ) and 56 patients (65.1%), respectively. Regardless of the qualification us ed in the initial CS biopsy or cytology, over 90% of the subsequent smears resulted in a benign diagnosis. Biopsy outcomes after CS diagnoses of ASCUS -P, ASCUS-R, and ASCUS-C showed SIL in 80%, 53%, and 66% of patients, respe ctively. For LB diagnoses, subsequent smears detected SIL in 33% of patient s with a diagnosis of ASCUS-P, 22% of patients with a diagnosis of ASCUS-R, and 12% of patients with a diagnosis of ASCUS-C. Biopsy outcomes after LB diagnoses of ASCUS-P, ASCUS-R, and ASCUS-C showed SIL in 68%, 64%, and 66% of patients, respectively. CONCLUSIONS, There appears to be no statistically valid benefit from a clin ical point of view in qualifying an ASCUS interpretation by either CS or LB , except for CS evaluation of patients with a diagnosis of ASCUS-P. Cancer (Cancer Cytopathol) 2001;93:93-99. (C) 2001 American Cancer Society.