Diagnostic Approach to Patients with Atypical Squamous Cells of Undetermined Significance Cytologic Findings on Cervix

Abstract

BACKGROUND: Atypical squamous cells of undetermined significance (ASCUS) is a term that refers to inflammatory, reactive and reparative processes which are atypical and of higher level and insufficient to be classified as cervical intraepithelial lesions (CIN). AIMS: Examine of frequency of HPV infection in ASCUS lesions and regression, stagnation and progression during six-month period. SUBJECTS AND METHODS: Prospective study was conducted over a period of 3 years. In private gynecological ambulance "Dr Mahira Jahic". Analysis of PAP smears and HPV typization have been done in 50 patients and PAP test has been repeated after six months. X² test was used for statistical analysis. RESULTS: Analysis of 1784 PAP smears showed normal results in 86,6% (N-1530), and abnormal in 13% (N-254). ASCUS in 7,4% (N-133) and ASC-H in 0,5% (N-9), LSIL in 4,4% (N-80), HSIL in 1,3% (N-24), CIN II in 1,2% (N-20), CIN III in 0,2% (N-4). Progression occurred in 18% (9), persistence in 74% (37) and regression in 8%. Patients with ASC-H lesion 0,5% (N-9), PH results showed 22% (N-2) Carcinoma in situ, 33% (N-3) CIN II, 22% (N-2) CIN I and 22% (N-2) chronic cervicitis. Patients with CIN I in 88% (N-7) were positive on HPV of high risk. Patients with persistent ASCUS result were positive in 51% (N-19). The number of CIN I lesions found in women with ASCUS is bigger and statistically significant (p<0,05) in relation to number of CIN I findings found in regular examinations. CONCLUSION: Monitoring women with ASCUS lesion, especially HPV positive to high risk group is the best way of selection of women who should be treated and monitored in order to prevent cervical cancer.