Prevalence of cervical intraepithelial neoplasia grades II/III and cervical cancer in patients with cytological diagnosis of atypical squamous cells when high-grade intraepithelial lesions (ASC-H) cannot be ruled out

Sao Paulo Medical Journal

Andréa Cytryn²  Fábio Bastos Russomano¹  Maria José De Camargo¹  Lucília Maria Gama Zardo¹  Nilza Maria Sobral Rebelo Horta¹  Rachel De Carvalho Silveira De Paula Fonseca¹  Maria Aparecida Tristão¹  Aparecida Cristina Sampaio Monteiro¹ 

[1] ,Hospital Geral de IpanemaRio de Janeiro,Brazil

关键词: Cytology;    Colposcopy;    Cervical intraepithelial neoplasia;    Uterine cervical neoplasm;    Cervix uteri;    Citologia;    Colposcopia;    Neoplasia intra-epitelial cervical;    Neoplasias do colo do útero;    Colo do útero;   

DOI  :  10.1590/S1516-31802009000500007

来源: SciELO

【 摘 要 】

CONTEXT AND OBJECTIVE: The latest update of the Bethesda System divided the category of atypical squamous cells of undetermined significance (ASCUS) into ASC-US (undetermined significance) and ASC-H (high-grade intraepithelial lesion cannot be ruled out). The aims here were to measure the prevalence of pre-invasive lesions (cervical intraepithelial neoplasia, CIN II/III) and cervical cancer among patients referred to Instituto Fernandes Figueira (IFF) with ASC-H cytology, and compare them with ASC-US cases. DESIGN AND SETTING: Cross-sectional study with retrospective data collection, at the IFF Cervical Pathology outpatient clinic. METHODS: ASCUS cases referred to IFF from November 1997 to September 2007 were reviewed according to the 2001 Bethesda System to reach cytological consensus. The resulting ASC-H and ASC-US cases, along with new cases, were analyzed relative to the outcome of interest. The histological diagnosis (or cytocolposcopic follow-up in cases without such diagnosis) was taken as the gold standard. RESULTS: The prevalence of CIN II/III in cases with ASC-H cytology was 19.29% (95% confidence interval, CI, 9.05-29.55%) and the risk of these lesions was greater among patients with ASC-H than with ASC-US cytology (prevalence ratio, PR, 10.42; 95% CI, 2.39-45.47; P = 0.0000764). Pre-invasive lesions were more frequently found in patients under 50 years of age with ASC-H cytology (PR, 2.67; 95% CI, 0.38-18.83); P = 0.2786998). There were no uterine cervical cancer cases. CONCLUSION: The prevalence of CIN II/III in patients with ASC-H cytology was significantly higher than with ASC-US, and division into ASC diagnostic subcategories had good capacity for discriminating the presence of pre-invasive lesions.

【 授权许可】

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