Cervical atypical cells-cannot exclude a premalignant high-grade lesion (ASC-H)

Células del cuello uterino con atipias que no descartan una lesión de alto grado (ASC-H) con premalignidad

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Margelys Betania Peña Villasmil
Genesis Geraldinet Moreno Vivas
Morelva Toro de Méndez
Juan Leonardo Marquez

Abstract

Introduction: the presence of atypical squamous cells-cannot exclude a high-grade squamous intraepithelial lesion (ASC-H) is significant, for approximately 50% could correspond to a cervix premalignant lesion. Objective: to describe the most frequent cytomorphological alterations on cervical cytology categorized as ASC-H, associated with a clinically significant histologically proven lesion. Methodology: this was a retrospective study performed at the cytology laboratory of the School of Pharmacy and Bioanalysis of Andes University and the Cancer Prevention Clinic of the Anti-Cancer Society in Merida-Venezuela, on cases with an ASC-H result on cervical cytology, analyzed between January 2010 and December 2016. Results: abnormal histopathological results were found in 35.8% (19/53) of cases: 22.6% had only an infection by HPV and 13.2% a premalignant lesion (CIN) combined with a HPV infection. 73.7% with CIN and/or HPV presented atypical immature metaplastic cells with hyperchromasia (78%), anisokaryosis (100%), and irregular nuclear membrane chromatin (92.9%), on a non-inflammatory background. Conclusions: the most frequent cytomorphological alterations on cervical cytology categorized as ASC-H associated with a significant histologically proven lesion were: anisokaryosis, hyperchromasia and irregular nuclear membrane chromatin, on a clean background. The same atypical cells were common in the CIN 1, 2 or 3 and/or HPV groups, showing statistical significant differences (p<0.05).

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References

López-Alegría F., Soares L., Poblete O. Follow-up of women with atypical squamous cells cannot exclude high-grade squamous intraepithelial lesions (ASC-H). Sao Paulo Med J. 2014;132(1):15-22.

Massad L., Einstein M., Huh W. Katki H., Kinney W., Schiffman M., Solomon D., Wentzensen N., Lawson H. 2012 ASCCP Consensus Guidelines Conference. 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. Obstet Gynecol. 2013;121:829-846. doi: 10.1097/AOG.0b013e3182883a34.

Davey D. Cytopathology update on atypical squamous cells. J Low Genit Tract Dis. 2005;9:124-129.

Abdul-Karim F., Powers C., Berek J., Sherman M., TabbaraS.,Sidawy M. En:Nayar R., Wilbur D.Editors.The Bethesda System for Reporting Cervical Cytology Definitions, Criteria, and Explanatory Notes. Springer. 3° ed. 2015, Cap. 4: Atypical squamous Cells. Pags:103-134.

Gilani S., Tashjian R., Fathallah L. Cervical cytology with a diagnosis of atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H): a follow-up study with corresponding histology and significance of predicting dysplasia by human papillomavirus (HPV) DNA testing. Arch GynecolObstet. 2010;289:645–648.

Patton A., Duncan L., Bloom L., Phaneuf G., Zafar N. Atypical squamous cells, cannot exclude a high-grade intraepithelial lesion and its clinical significance in postmenopausal, pregnant, postpartum, and contraceptive-use patients. Cancer. 2008;114(6):481-8.

López M., Guillén M., QuinteroM., Cruz J., Puig J., Toro M. Infección por virus papiloma humano en pacientes con células escamosas atípicas de un programa de pesquisa de cáncer cervical. Obstetricia y Ginecología Venezuela. 2012;72(4):19-27.

Türkmen I., Bassüllü N., Korkmaz P., Günenç B., Baykal C., Güdücü N., Isçi H., Dünder I., BülbülG. Patients with Epithelial Cell Abnormality in PAP Smears: Correlation of Results with Follow-Up Smears and Cervical Biopsies. 2013. Turkish Journal of Pathology. 2012;29:179-181.

Selvaggi S. Reporting of atypical squamous cells cannot exclude a high-grade squamous intraepithelial lesion (ASC-H) on cervical samples: Is it significant?.Diagn. Cytopathol. 2003;29:38–41.

Bonvicino A., Huitron S., Fadare, O. Papanicolaou test interpretations of “atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion’’: an investigation of requisite duration and number of colposcopic procedures to a definitive diagnosis of highgrade dysplasia in routine practice. Cancer. 2007;111(6):477-81.

Toro de Méndez M, López de Sánchez M, Omaña de Uzcátegui T, Altuve de Acuña F, Guillén FerraroM. Hallazgos histopatológicos asociados acélulas glandulares atípicas. Revista de la Facultad de Farmacia. 2005;47:2-4.

Mendez L., Rodriguez A., Lopez M., Toro M. Signos citológicos no clásicos asociados a la infección por el Virus del Papiloma Humano (VPH) en pacientes de Merida, Venezuela. InvestClin. 2011;52(2):162-169.

McGrath C. ASCUS in papanicolaou Smears: Problems, Controversies, and potential Future Directions. Pathology Patterns Reviews. 2002;117:15-22.

Allí P., Ali S. Atypical squamous cells of undertermined significance rule out high grade squamous intraepithelial lesion: cytopathologic characteristics and clinical correlates. Diagnostic Cytopathology. 2003;28:308-312.

Michelow P., Hartman I., Schulze D., Lamla-Hillie S., Williams S., Levin S., Firnhaber C. Atypical squamous cells, cannot exclude high grade aquamous intraepithelial (ASC-H) in HIV-positive women. Cytojournal. 2010;7:8.

Atjimakul T., Boonyapipat S., Chichareon S., Phukaoloun. Citomorphologic and clinical factors of having high grade cervical intraepithelial neoplasia/invasive carcinoma in women with atypical squamous cells,cannot exclude high grade squamous intraepithelial lesions (ASC-H) smears. Med Assoc Thai. 2013;96(11):13891394.

Chivukula M., Shidham V.ASC-H in Pap test-definitive categorization of cytomorphological spectrum. Cytojournal. 2010;10(3):14.

Johnston E., Logani S. Cytologic diagnosis of atypical squamous cells of undetermined significance in perimenopausal and postmenopausal women: lessons learned from human Papillomavirus DNA testing. Cancer. 2007;111:160-165.

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