Abstract | BACKGROUND: The Bethesda system classifies smears that suggest an underlying cervical intraepithelial neoplasia (CIN) as ASC ( atypical squamous cell) smears. ASC smears are subdivided into ASCUS (of undetermined significance) and ASCH (cannot exclude a high-grade lesion). Today the management of ASCUS is a triage with HR-HPV testing and colposcopy is recommended for ASCH. The aim was to conduct a study on ASC smears to determine DNA ploidy measurement for the detection of CIN2+. METHODS: The link between a suspect DNA ploidy assessed by image cytometry and/or a positive HR-HPV testing was analyzed on 69 ASCUS and 82 ASCH smears, and the presence of CIN2+ within 12 months after ASC diagnosis. The ploidy was suspect in case of aneuploidy, multiploidy, or in the presence of cells with a DNA content >5c or >9c. RESULTS: Every woman who had a CIN2+ had a suspect DNA profile in the ASCUS smears and every woman except 1 was HR-HPV-positive. The link between a positive HR-HPV test or a suspect DNA profile or both and a CIN2+ was high (P = .019, .023, and .008, respectively). The presence of >9c cells was particularly linked to CIN2+ (P = .0031). In all, 90.9% and 87.9% of the ASCH smears with CIN2+ were, respectively, HR-HPV positive or had a suspect ploidy (P = .0000 and P = .0043), and the presence of >9c cells was also linked to CIN2+ (P = .003). CONCLUSIONS: HR-HPV testing and determination of the ploidy profile with special attention to 9c-exceeding cells could be accurate for a better management of ASC smears.
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Authors | Marianne Lorenzato, Stephanie Caudroy, Jean-Marie Nou, Veronique Dalstein, Karine Joseph, Salima Bellefqih, Anne Durlach, Corinne Thil, Francine Dez, Dominique Bouttens, Christine Clavel, Philippe Birembaut |
Journal | Cancer
(Cancer)
Vol. 114
Issue 4
Pg. 263-9
(Aug 25 2008)
ISSN: 0008-543X [Print] United States |
PMID | 18618504
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | (c) 2008 American Cancer Society. |
Topics |
- Cervix Uteri
(pathology)
- Female
- Humans
- Papillomaviridae
(isolation & purification)
- Ploidies
- Retrospective Studies
- Uterine Cervical Neoplasms
(diagnosis)
- Vaginal Smears
- Uterine Cervical Dysplasia
(diagnosis)
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