Clinical Significance of a Cervical Cytologic Diagnosis of Atypical Squamous Cells of Undetermined Significance: Qualitification and HPV DNA Detection.
- Author:
Hye Won JEON
;
Kwang Bum BAI
- Publication Type:Original Article
- Keywords:
Atypical squamous cell of undetermined significance;
Qualification;
Human papillomavirus;
Cervical intraepithelial neoplasia
- MeSH:
Biopsy;
Cervical Intraepithelial Neoplasia;
Diagnosis*;
DNA*;
Female;
Humans;
Incidence;
Papanicolaou Test;
Sensitivity and Specificity
- From:Korean Journal of Gynecologic Oncology and Colposcopy
2000;11(4):381-388
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: To evaluate qualification and determine the usefulness of human papillomavirus(HPV) DNA testing in women with cytologic smears read as atypical squamous cell of undetermined significance (ASCUS). METHOD: The study was based on 88 women with cytologic smears reported of ASCUS favoring either a reactive process or squamous intraepithelial lesion (SIL) from July 1999 to June 2000. Cytologic examination by Papanicolaou smear was based on the Bethesda System and cervical biopsy was done via coloscopy. the presence of high risk HPV DNA was determined with Hybrid capture assay. RESULTS: The overall incidence of cervical intraepithelial lesion (CIN) was higher in the group with ASCUS favoring SIL than in the group with ASCUS favoring reactive process(42.2 % vs 18.6 %; p<0.05). Women with ASCUS favoring SIL were 9.1 times more likely to have high grade SIL(CIN II/III) develop than were women group with ASCUS favoring reactive process(95% confidence interval, 1.08-76.0). High-risk HPV DNA was demonstrated in 39.8%(35 cases) and was associated a 8.8 times increased likelihood of histologic conformation of CIN(95% confidence interval, 3.09-24.7). The sensitivity of HPV assay for any CIN was 74% and specificity was 75%, whereas the corresponding values for the repeat Pap smear was 67% and 33%, respectively. CONCLUSION: Women with ASCUS favoring SIL was associated with a relatively high risk that the women was harboring SIL. The addiction of a high-risk HPV DNA assay to cytologic examination appears to provide for early detection of high grade CIN in women with ASCUS.
