Histopathology of Women with “Atypical Squamous Cells Cannot Exclude High-Grade Squamous Intraepithelial Lesion” (ASC-H) Smears

Abstract

Objectives: To evaluate prevalence of underlying significant pathologies among women with cervical smears<br />rated as ‘atypical squamous cells cannot exclude high grade squamous intraepithelial lesion (ASC-H)', as well as<br />associated risk factors. Methods: Medical records were reviewed of all consecutive women with ASC-H smears who<br />had undergone colposcopy at Srinagarind Hospital from January 2008 to July 2016. Significant pathology results<br />included cervical intraepithelial neoplasia (CIN) 2-3, adenocarcinoma in situ (AIS), endometrial hyperplasia, and<br />cancer of any original site. Result: During the study period, 133 women with ASC-H were reviewed. The mean age<br />was 45.3 years (range 21-72). The histopathologic results for the 133 women were as follows: no lesions (58; 43.6%),<br />CIN 1 (34; 25.6%), CIN 2-3 (33; 24.8%), AIS (2; 1.5%), and cervical cancer (6; 4.5%). The overall rate of significant<br />pathology was 30.8% (95% confidence interval, 22.9%-38.8%). Women younger than 40 years old carried a higher<br />risk of harboring significant lesions when compared to older women (41.7% versus 27.8%, respectively). There was<br />no significant impact of parity and menopausal status on the risk of significant pathology results. Conclusion: The<br />rate of significant histopathologies among women with ASC-H smears in this study was approximately 31% and the<br />associated risk factor was patient age.