Histopathology of Women with “Atypical Squamous Cells Cannot Exclude High-Grade Squamous Intraepithelial Lesion” (ASC-H) Smears

• Published in: Asian Pacific journal of cancer prevention : APJCP Vol. 20; no. 3; pp. 683 - 686
• Main Authors: Ratree, Sasivimon, Kleebkaow, Pilaiwan, Aue-Aungkul, Apiwat, Temtanakitpaisan, Amornrat, Chumworathayi, Bandit, Luanratanakorn, Sanguanchoke
• Format: Journal Article
• Language: English
• Published: Thailand West Asia Organization for Cancer Prevention 2019
• Subjects: Atypical squamous cells; cervical cancer; ASC-H; cervical intraepithelial neoplasia
• ISSN: 1513-7368; 2476-762X
• DOI: 10.31557/APJCP.2019.20.3.683

Objectives: To evaluate prevalence of underlying significant pathologies among women with cervical smears rated as ‘atypical squamous cells cannot exclude high grade squamous intraepithelial lesion (ASC-H)’, as well as associated risk factors. Methods: Medical records were reviewed of all consecutive women with ASC-H smears who had undergone colposcopy at Srinagarind Hospital from January 2008 to July 2016. Significant pathology results included cervical intraepithelial neoplasia (CIN) 2-3, adenocarcinoma in situ (AIS), endometrial hyperplasia, and cancer of any original site. Result: During the study period, 133 women with ASC-H were reviewed. The mean age was 45.3 years (range 21-72). The histopathologic results for the 133 women were as follows: no lesions (58; 43.6%), CIN 1 (34; 25.6%), CIN 2-3 (33; 24.8%), AIS (2; 1.5%), and cervical cancer (6; 4.5%). The overall rate of significant pathology was 30.8% (95% confidence interval, 22.9%-38.8%). Women younger than 40 years old carried a higher risk of harboring significant lesions when compared to older women (41.7% versus 27.8%, respectively). There was no significant impact of parity and menopausal status on the risk of significant pathology results. Conclusion: The rate of significant histopathologies among women with ASC-H smears in this study was approximately 31% and the associated risk factor was patient age.