Abstract
Objective : The clinical significance of atypical squamous cells (ASC ; Bethesda 2001), which may be categorized as being of undetermined significance (ASC-US) or not classifiable (ASC-H), is discussed.
Study Design : A total of 39,001 cases who underwent cytologic examination of the uterine cervix between 2003-2004 at the Cancer Institute Hospital, Tokyo, were enrolled. High-risk type HPVs were detected by Hybrid Capture II or PCR followed by direct sequenceing.
Results : Among the 39,001 cases, 74 (0.19%) cases were reported to have ASCs by the cytopathologists. Among the 24 cases in which the HPV-DNA test was conducted, high-risk type HPVs were detected in 79.2% of the cases including 13 (81.3%) of ASC-US cases and 6 (75.0%) of ASC-H cases. Histopathological examination revealed high-grade intraepithelial lesions in 3 (37.5%) out of the 8 ASC-US cases, while all the 6 (75%) of the 6 ASC-H cases were found to have high-grade intraepithelial lesions. Among the ASC-US cases, while 3 (50%) out of the 6 cases stet high-risk HPVs were found to have high-grade intraepithelial lesion, intraepithelial lesions were also found in 2 cases negative for high-risk HPVs.
Conclusion : According to the Bethesda System 2001, screenig for ASCs which are suggestive of dysplasia or CIS would be useful to improve the sensitivity of uterine cervical cytology, although the falsenegative rate may increase. HPV-DNA testing combined with cytologic examinations would be useful to improve the efficient detection of highgrade intraepithelial lesions in ASC-US cases.
