DOI QR코드

DOI QR Code

Incidence of High Grade Squamous Intraepithelial Lesions in Patients with Atypical Squamous Cells of Undetermined Significance Papanicolaou Smears at Naresuan University Hospital

  • Heng, Suttichai (Department of Obstetrics and Gynecology, Faculty of Medicine, Naresuan University) ;
  • Sirichaisutdhikorn, Daranee (Department of Obstetrics and Gynecology, Faculty of Medicine, Naresuan University)
  • 발행 : 2016.05.01

초록

Purpose: To determine the incidence of high-grade cervical intraepithelial neoplasia (CIN2-3) among patients with atypical squamous cells of undetermined significance (ASC-US) Papanicolaou (Pap) smears. Materials and Methods: One-hundred and eighty-seven patients with ASC-US Pap smears who underwent colposcopy with histological study were enrolled between September 2007 and August 2015. Patient factors (including age, parity, current pills used, HIV status, age at first sexual intercourse and number of sexual partners) were obtained. Logistic regression analysis was used to evaluate clinical factors associated with CIN2-3. Results: CIN was diagnosed in 92 of 187 women (49.2%). Sixty-one of these (32.6%) had CIN1 and 31 (16.6%) had CIN2-3. There was no woman who had invasive cancer. There was no correlation of high-grade CIN with factors in this study including age, parity, current pills used, HIV status, age at first sexual intercourse and number of sexual partners. Conclusions: Data from this study showed no invasive cervical cancer was found in patients with ASC-US. There was no patient factor associated with high grade intraepithelial neoplasia in patients with ASC-US Pap smears.

키워드

참고문헌

  1. Catteau X, Simon P, Noel JC (2014). Evaluation of the oncogenic human papillomavirus DNA test with liquid-based cytology in primary cervical cancer screening and the importance of the ASC/SIL ratio: A Belgian stydy. ISRN Obstet Gynecol, 2014, 1-5.
  2. De Vet HC, Knipschild PG, Sturmans F (1993). The role of sexual factors in the aetiology of cervical dysplasia. Int J Epidemiol, 22, 798-803. https://doi.org/10.1093/ije/22.5.798
  3. Ferlay J, Soerjomataram I, Ervik M, et al (2013). GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer. Available from: http://globocan.iarc.fr.
  4. Ibanez R, Moreno-Crepi J, Sarda M, et al (2012) Prediction of cervical intraepithelial neoplasia grade 2+ (CIN 2+) using HPV DNA testing after a diagnosis of atypical squamous cell of undetermined significance (ASC-US) in Catalonia, Spain. BMC Infectious Diaseas, 12, 1-8. https://doi.org/10.1186/1471-2334-12-1
  5. Katki HA, Schiffman M, Castle PE, et al (2013). Benchmarking CIN3+ risk as the basis for incorporating HPV and Pap cotesting into cervical screening and management guidelines. J Low Genit Tract Dis, 17, 28-35. https://doi.org/10.1097/LGT.0b013e318258bf5b
  6. Katki HA, Schiffman M, Castle PE, et al (2013). Five-year risk of CIN3+ and cervical cancer for women with HPV testing of ASC-US Pap results. J Low Genit Tract Dis, 17, 36-42. https://doi.org/10.1097/LGT.0b013e3182854253
  7. Kietpeerakool C, Tangjitgamol S, Srisomboon J (2014). Histopathological outcomes of women with abnormal cervical cytology: a review of literature in Thailand. Asian Pac J Cancer Prev, 12, 6489-94.
  8. Kinney WK, Manos MM, Hurley LB, et al (1998). Where's the high-grade cervical neoplasia? The importance of minimally abnormal Papanicolaou diagnoses. Obstet Gynecol, 91, 973-6.
  9. Massad LS, Einstein MH, Huh WK, et al (2013). 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. Obstet Gynecol, 121, 829-46. https://doi.org/10.1097/AOG.0b013e3182883a34
  10. Parazzini F, La Vecchia C, Negri E, et al (1992). Risk factors for cervical intraepithelial neoplasia. Cancer, 69, 2276-82. https://doi.org/10.1002/1097-0142(19920501)69:9<2276::AID-CNCR2820690912>3.0.CO;2-Q
  11. Parazzini F, Sideri M, Restelli S, et al (1995). Determinants of high-grade dysplasia among women with mild dyskeratosis on cervical smear. Obstet Gynecol, 86, 754-7. https://doi.org/10.1016/0029-7844(95)00281-U
  12. Safaeian M, Solomon D, Wacholder S, Schiffman M, Castle P (2007). Risk of precancer and follow-up management strategies for women with human papillomavirus-negative atypical squamous cells of undetermined significance. Obstet Gynecol, 109, 1325-31. https://doi.org/10.1097/01.AOG.0000263461.71732.40
  13. Shlay JC, Dunn T, Byers T, et al (2000). Prediction of cervical intraepithelial neoplasia grade 2-3 using risk assessment and human papillomavirus testing in women with atypia on papanicolaou smears. Obstet Gynecol, 96, 410-6.
  14. Won KH, Lee JY, Cho HY, et al (2015). Impact of age on the fasle negative rate of human papillomavirus DNA test in patients with atypical squamous cells of undetermined significance. Obstet Gynecol Sci, 58, 117-23. https://doi.org/10.5468/ogs.2015.58.2.117
  15. Wright TC, Sun XW, Koulos J (1995). Comparison of management algorithms for the evaluation of women with low-grade cytologic abnormalities. Obstet Gynecol, 85, 202-10. https://doi.org/10.1016/0029-7844(94)00373-L
  16. Wright TC, Stoler MH, Behrens CM, et al (2015). Primary cervical cancer screening with human papillomavirus: end of study results from the ATHENA study using HPV as the first-line screening test. Gynecol Oncol, 136, 189-97. https://doi.org/10.1016/j.ygyno.2014.11.076