Cumulative High-Grade Squamous Intraepithelial Lesion Rate and Need for Surgical Intervention of Atypical Squamous Cells of Undetermined Significance Cytology-Diagnosed Patients: A Prospective Study

Gynecol Obstet Invest. 2017;82(3):247-251. doi: 10.1159/000448138. Epub 2016 Sep 13.

Abstract

Objective: Τhe study aimed to study the rate of atypical squamous cells of undetermined significance (ASCUS) that progressed to high-grade squamous intraepithelial lesions (HGSIL), as well as the number of patients who finally necessitated a surgical intervention during follow-up.

Methods: A prospective study was conducted on patients admitted for colposcopy during 2007-2012. We exclusively included those who presented with newly ASCUS diagnosis, while patients with a history of cervical intraepithelial neoplasia (CIN) were excluded. Primary end points were the cumulative rate of HGSIL during follow-up and the rate of surgical procedures performed because of such lesions.

Results: There were 134 ASCUS cases included. Overall, there were 48 (35.8%) surgical excision procedures performed to treat or eliminate HGSIL during the follow-up period. According to the final histopathology of surgical specimens, the cumulative rate of CIN2 or higher cervical lesions was 28.4% (n = 38).

Conclusion: The cumulative rate of CIN2+ during follow-up period was almost 30% for patients with ASCUS, with the necessity for interventional treatment being even higher.

Keywords: Atypical squamous cells of undetermined significance; Cervical intraepithelial neoplasia; High-grade squamous intraepithelial lesion; Loop electrosurgical excision procedure.

MeSH terms

  • Adult
  • Aged
  • Atypical Squamous Cells of the Cervix / pathology*
  • Colposcopy
  • Female
  • Humans
  • Middle Aged
  • Pregnancy
  • Prospective Studies
  • Squamous Intraepithelial Lesions of the Cervix / pathology*
  • Squamous Intraepithelial Lesions of the Cervix / surgery*
  • Uterine Cervical Dysplasia / pathology
  • Uterine Cervical Neoplasms / pathology