The significance of the papanicolaou smear diagnosis of low-grade squamous intraepithelial lesion cannot exclude high-grade squamous intraepithelial lesion

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dc.contributor.author Nasser, Selim M.
dc.contributor.author Cibas, Edmund S.
dc.contributor.author Crum, Christopher P.
dc.contributor.author Faquin, William C.
dc.date.accessioned 2017-02-02T10:19:31Z
dc.date.available 2017-02-02T10:19:31Z
dc.date.copyright 2003 en_US
dc.identifier.issn 1934-662X en_US
dc.identifier.uri http://hdl.handle.net/10725/5158
dc.description.abstract BACKGROUND Cervical cytologic specimens that show a low-grade squamous intraepithelial lesion (LSIL) occasionally contain a few cells that are suspicious for, but not diagnostic of, a high-grade squamous intraepithelial lesion (HSIL). In such cases, a diagnosis of LSIL cannot exclude HSIL is rendered. The objective of the current study was to assess the positive predictive value (PPV) for HSIL in follow-up cervical biopsies for these cases. METHODS One hundred forty-four women with a Papanicolaou (Pap) diagnosis of LSIL cannot exclude HSIL and their follow-up cervical biopsies were reviewed. Results were compared with a control group of 155 women with a Pap diagnosis of LSIL. A subset of biopsies was tested and typed for human papillomavirus (HPV) DNA by polymerase chain reaction amplification using consensus primers followed by restriction fragment length polymorphism analysis. HPVs were scored as low-risk or high-risk types. RESULTS Women with LSIL cannot exclude HSIL had a higher incidence of HSIL (PPV = 29%) on follow-up cervical biopsy than the control group (PPV = 15%, P < 0.01). In addition, SIL, indeterminate grade was diagnosed in 10% of cervical biopsies in the study group as compared with 4% in controls. Review of Pap smears from the study group showed that there were 3 types of cells suspicious for a high-grade lesion: atypical squamous metaplastic cells (62%), atypical keratinized cells (20%), and dysplastic cells of borderline nuclear-to-cytoplasm ratio (18%). HPV analysis confirmed the presence of high-risk HPV types in the study cases with high-grade cervical biopsies. CONCLUSIONS Women with a Pap diagnosis of LSIL cannot exclude HSIL appear to be more likely to harbor a high-grade lesion than those diagnosed with LSIL alone. Its use appears warranted. Women with this diagnosis merit appropriate clinical follow-up to exclude HSIL. Cancer (Cancer Cytopathol) 2003. © 2003 American Cancer Society. en_US
dc.language.iso en en_US
dc.title The significance of the papanicolaou smear diagnosis of low-grade squamous intraepithelial lesion cannot exclude high-grade squamous intraepithelial lesion en_US
dc.type Article en_US
dc.description.version Published en_US
dc.author.school SOM en_US
dc.author.idnumber 200804624 en_US
dc.author.department N/A en_US
dc.description.embargo N/A en_US
dc.relation.journal Cancer Cytopathology en_US
dc.journal.volume 99 en_US
dc.journal.issue 5 en_US
dc.article.pages 272-276 en_US
dc.identifier.doi http://dx.doi.org/10.1002/cncr.11721 en_US
dc.identifier.ctation Nasser, S. M., Cibas, E. S., Crum, C. P., & Faquin, W. C. (2003). The significance of the Papanicolaou smear diagnosis of low‐grade squamous intraepithelial lesion cannot exclude high‐grade squamous intraepithelial lesion. Cancer Cytopathology, 99(5), 272-276. en_US
dc.author.email selim.nasser@lau.edu.lb en_US
dc.identifier.tou http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php en_US
dc.identifier.url http://onlinelibrary.wiley.com/doi/10.1002/cncr.11721/full en_US
dc.author.affiliation Lebanese American University en_US

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