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Cytology and outcome of LSIL: cannot exclude HSIL compared to ASC-H
1Department of Pathology, University of Alberta, Calgary, Alberta, Canada.
Summary
Low-grade squamous intraepithelial lesion cannot exclude high-grade squamous intraepithelial lesion (LSIL-H) shows a higher positive outcome rate than atypical squamous cells cannot exclude HSIL (ASC-H). Specific cytological features correlate with outcomes in LSIL-H, unlike ASC-H.
Area of Science:
- Cervical cytology and pathology
- Gynecologic oncology
- Diagnostic cytopathology
Background:
- Distinguishing between LSIL-H and ASC-H is crucial for patient management.
- Previous studies have not fully elucidated the cytological differences and clinical outcomes associated with these classifications.
Purpose of the Study:
- To compare the cytological features and clinical outcomes of LSIL-H and ASC-H Pap tests.
- To identify specific cytological markers that predict clinical outcomes in LSIL-H and ASC-H cases.
Main Methods:
- Retrospective review of 89 LSIL-H and 86 ASC-H Pap tests by two pathologists.
- Evaluation of 52 atypical features against a checklist.
- Correlation of cytological findings with 2-year histology follow-up for clinical outcome (CIN II/III or AIS).
Main Results:
- LSIL-H had a higher positive outcome rate (49%) compared to ASC-H (38%).
- Increased nuclear-to-cytoplasmic ratio was the most common atypical feature in both groups.
- Round nuclei and naked nuclei were significant predictors of positive outcome in LSIL-H, but not in ASC-H.
Conclusions:
- LSIL-H is diagnostically distinct from ASC-H due to a higher frequency of adverse outcomes.
- Specific cytological features, such as round nuclei and naked nuclei, are associated with poorer outcomes in LSIL-H cases.
