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Borderline nuclear change in cervical smears: five-year follow-up
A Grace1, G Maguire, S Doherty
1Department of Pathology, Royal College of Surgeons in Ireland, Dublin, Ireland.
Diagnostic Cytopathology
|November 5, 2003
Summary
Borderline nuclear changes (BNC) in cervical smears have unpredictable outcomes. A study found a 4.05% progression to high-grade dyskaryosis, justifying current intensive follow-up protocols.
Area of Science:
- Gynecologic Pathology
- Cervical Cancer Screening
- Cytopathology
Background:
- Borderline nuclear changes (BNC) represent 5-20% of cervical smears with uncertain prognoses.
- Current management involves repeated cervical smears and colposcopy if changes persist, raising concerns about overtreatment.
Purpose of the Study:
- To determine the natural history and outcomes of patients diagnosed with BNC.
- To evaluate the appropriateness of current management protocols for BNC in the laboratory's patient cohort.
Main Methods:
- Retrospective follow-up study of 808 patients with a BNC diagnosis.
- Analysis of progression to high-grade dyskaryosis over the follow-up period.
Main Results:
- A 4.05% progression rate to high-grade dyskaryosis was observed among patients with BNC.
- The majority of progressions were identified within the first year of follow-up.
Conclusions:
- The observed progression rate supports the current intensive follow-up strategy for BNC.
- Development of a reliable triage tool is needed to better select patients requiring intervention.