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Cytologic observations preceding high grade squamous intraepithelial lesions
1Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, USA.
Acta Cytologica
|July 1, 1995
Summary
Annual cervical cancer screening is valuable. Most high-grade squamous intraepithelial neoplasia (HSIL) cases show prior abnormalities on cytology, indicating the screening
Area of Science:
- Gynecologic Oncology
- Cytopathology
Background:
- A significant proportion of women may develop high-grade squamous intraepithelial neoplasia (HSIL) despite negative initial cervical cytology.
- The prevalence of spontaneous HSIL could question the efficacy of annual cervical cancer screening.
Purpose of the Study:
- To evaluate the validity of high HSIL prevalence after negative cytology.
- To assess the diagnostic value of annual cervicovaginal cytologic smear examinations.
Main Methods:
- Retrospective analysis of cytologic smears from 82 patients with confirmed HSIL.
- Evaluation of smears obtained within 24 months prior to HSIL diagnosis.
Main Results:
- 90% of HSIL cases showed abnormal cervical cytology within 24 months prior to diagnosis (88% at 24 months, 96% at 12 months).
- Low-grade squamous intraepithelial neoplasia (LSIL) was present in 45% of smears; others showed human papillomavirus (HPV)-associated changes.
- Only three cases had persistently negative cytology.
Conclusions:
- Annual cytologic smear examinations are valuable for detecting cervical epithelial abnormalities and HPV-related changes.
- Awareness of HPV-associated cellular changes aids in identifying women at risk for HSIL and precursor lesions.