Is the low-grade squamous intraepithelial lesion/atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion category associated with cervical intraepithelial neoplasia 2?

Cetiner H., Kır G., Kaygusuz E., Sağlıcan Y. , Kabaca C.

Acta cytologica, vol.57, pp.581-4, 2013 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 57
  • Publication Date: 2013
  • Doi Number: 10.1159/000353824
  • Title of Journal : Acta cytologica
  • Page Numbers: pp.581-4


Objective: A number of cervical smears may exhibit unequivocal low-grade squamous intraepithelial lesions (LSIL) in association with atypical cells cytomorphologically suspicious, but not sufficient to be interpreted as high-grade squamous intraepithelial lesions (HSIL). These lesions are presently called LSIL, atypical squamous cells cannot exclude HSIL (LSIL/ASC-H). Previous studies have shown that LSIL/ASC-H and ASC-H are both equivocal for HSIL and have a high risk of underlying HSIL. However, in researching the literature only two studies were found which rendered the results as cervical intraepithelial neoplasia (CIN) 2 and CIN3 separately. The purpose of this study was to compare the distribution of biopsy results for CIN2 and CIN3 in patients with ASC-H, HSIL, and LSIL/ASC-H.

Study Design: Between January 2005 and December 2011, cervicovaginal smears (98,594) with a diagnosis of ASC-H, LSIL, LSIL/ASC-H, or HSIL were re-evaluated to determine the prevalence of future lesion development.

Results: A total of 252 patients who had histologic follow-up within a year were selected. Among these, LSIL/ASC-H (31.7%) had the highest prevalence of CIN2 between LSIL (9.3%), ASC-H (10%), and HSIL (16%). All differences were statistically significant.

Conclusion: Because of the high predictive value of CIN2, LSIL/ASC-H may have further importance, especially in women of different age groups.