Atypical Squamous Cells of Undetermined Significance: A Cytohistological Study in a Colposcopy Clinic

✍ Scribed by Helen C. Ettler; Mariamma G. Joseph; Patricia A. Downing; Neville G. Suskin; V. Cecil Wright

• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 64 KB
• Volume: 21
• Category: Article
• ISSN: 8755-1039
• DOI: 10.1002/(sici)1097-0339(199909)21:3<211::aid-dc14>3.0.co;2-s

✦ Synopsis

Cytohistologic correlation was performed by 3 observers on 100 atypical squamous cells of undetermined significance (ASCUS) cases from a colposcopy clinic. Our objectives were to: 1) subclassify ASCUS cases and determine their clinical significance; 2) assess the independent predictive value of different cytologic parameters for biopsy-proven dysplasia (BPD); and 3) calculate interobserver variability. The prevalence of BPD was 73% in the ASCUS favor dysplasia (AFD) group, and 27% in the ASCUS favor reactive (AFR) group (P Ͻ 0.001). The sensitivity of cervical cytology (AFD) for detecting BPD was 88.5%. Using multiple logistic regression, only nuclear membrane irregularity was found to be independently predictive of BPD (P Ͻ 0.0001). The interobserver agreement (kappa) was 0.41. Colposcopic smears were inferior to referring smears in detecting dysplasia, with 67% of patients having a referring diagnosis of dysplasia. In a colposcopy clinic population there is a high prevalence (73%) of BPD in the AFD group. Attention should be paid to nuclear membrane irregularity in the risk stratification of ASCUS cases.