Abstract
Objective : In this study, we attempted to verify how three companies of registered clinical laboratories judged ASC-H, a category of The Bethesda System (TBS), and reveal the current situations and issues.
Study Design : We looked into the cases judged as ASC-H from the first year of implementation of TBS, namely, 2009 for Company A and 2010 for Company B and Company C, to June 2012, and considered the ASC-H rate (ASC-H/ASC), age groups, histopathological diagnosis rates and histopathology results, re-examination rate after cytoscreenings, and the results in 38 clinical cases with the histopathological diagnosis of CIN2 or more that were suitable for microscopic re-examinations.
Results : The ASC-H/ASC rates during the first year of implementation of TBS were 18, 13 and 8% for Company A, Company B and Company C, respectively, and the corresponding rates in the year 2012 were 11, 6 and 10%, respectively. Age-group-wise, the highest rates were recorded in subjects in their 30s and 60s. Histopathological examination was conducted in 10, 25 and 36% of cases from Company A, Company B and Company C, respectively, and the diagnosis rate of CIN3, which was the predominant diagnosis, among these cases was 33, 24 and 37%, respectively. The re-examination rates after cytoscreening were 22, 40 and 15%, respectively.
The characteristic features of ASC-H were noted to be high nuclear density, disordered array of cells, and mild to moderate mitotic figures upon the cell clusters.
Conclusion : The ASC-H rate became about 10% that was recommended by TBS in 3-4 years after the implementations of TBS. It is important to pay attention to cell clusters since they may show nuclear density, disordered array, and mitoses.
