Abstract
Objective : To clarify of current status of “A typical squamous cells, cannot exclude high-grade intraepithelial lesion” (ASC-H), we assessed the temporal changes of status in patients with the cytological findings of ASC-H.
Study Design : We compared the frequency, age distribution, cytologic features and subsequent histological results in patients with ASC-H between the earlier 3-year period of 2009-11 and the later 3-year period of 2012-14.
Results : In the earlier 3-year period, 48 out of 236121 participants of mass screening for uterine cervical cancer (0.02%) were categorized as having ASC-H, while in the later 3-year period, 172 out of 221143 participants (0.08%) were categorized as having ASC-H ; the percentage being significantly higher in the later 3-year period. Among the cases with ASC-H, cervical biopsy revealed CIN2 or higher grade (≧CIN2) lesions in 33 cases (77.3%) in the earlier 3-year period and in 98 cases (60.1%) in the later 3-year period ; furthermore, CIN3 or higher grade (≧CIN3) lesions were found in 27 cases (60.0%) in the earlier 3-year period and in 57 cases (35.0%) in the later 3-year period. The positive predictive value of ASC-H for≧CIN2 lesions tended to be slightly lower in later 3-year period than that in the earlier 3-year period. The positive predictive value of ASC-H for≧CIN3 lesions was significantly lower in the later 3-year period than that in the earlier 3-year period.
Conclusion : The incidence of ASC-H in the later 3-year period was higher than that in the earlier 3-year period, presumably as a familiarity of the concept of ASC-H. Increase in the diagnosis rate of ASC-H could be the reason for the decrease of its positive predictive value for HSIL during the later 3-year period. Efforts are needed for appropriate application for ASC-H.
