Atypical squamous cells of undetermined significance—rule out high‐grade squamous intraepithelial lesion: Cytopathologic characteristics and clinical correlates
Atypical squamous cells of undetermined significance—rule out high‐grade squamous intraepithelial lesion: Cytopathologic characteristics and clinical correlates
复制标题
意义不明的非典型鳞状细胞——排除高级鳞状上皮内病变：细胞病理学特征和相关临床
作者：
P. Alli;Syed Z. Ali
子宫颈细胞学涂片中未确定意义的非典型鳞状细胞（ASCUS）的意义和临床处理一直是一个有争议的领域。本研究编制了一份标准列表，可用于识别归类为意义不明的非典型鳞状细胞的病例子集-排除新Bethesda系统术语中的高度鳞状上皮内病变（ASC-H），其最终诊断为宫颈上皮内瘤变（CIN）。检索了约翰霍普金斯医院1996-1998年3年期间的细胞病理学文件中的ASC‐H病例，这些病例具有明确的临床病理学随访（阴道镜检查和宫颈活检）。涂片进行审查，细胞形态学特征的研究，并进行临床相关性。45，428例妇科涂片中有257例（0.6%）诊断为ASC-H，其中72例进行了临床病理随访。在这72例病例中，35例（49%）随访时诊断为阴性/反应性（NR），而37例（51%）为CIN [CIN-I-18例（49%）和CIN II和III-19例（51%）]。CIN随访时ASC-H类别的显著细胞形态学差异（与NR随访相比）非典型细胞较少，更常出现分离或单个，更单形，核质（N/C）比更高，核染色质更浓，染色质更粗，分散不均匀，核膜不规则性更明显，缺乏核仁，染色中心或核沟，也没有煽动性的背景仔细注意细微的细胞形态学特征可能有助于更明确地将ASC-H术语细分为NR和CIN诊断。细胞病理学诊断。2003;28：308-312.© 2003 Wiley利斯公司
The significance and clinical management of atypical squamous cells of undetermined significance (ASCUS) on cervical cytologic smears has been an area of much controversy. This study compiled a list of criteria useful in identifying the subset of cases that would be categorized as atypical squamous cells of undetermined significance‐ rule out high‐grade squamous intraepithelial lesion (ASC‐H) in the new Bethesda System terminology, which eventuate in a diagnosis of cervical intraepithelial neoplasia (CIN). The cytopathology files at Johns Hopkins Hospital were searched for ASC‐H cases from the 3‐yr period 1996–1998, which had definitive clinicopathologic follow‐up (colposcopy and cervical biopsies). The smears were reviewed, cytomorphologic features studied, and clinical correlations performed. ASC‐H was diagnosed in 257 of 45,428 gynecologic smears (0.6%), 72 having had clinicopathologic follow‐up. Of these 72 cases, 35 (49%) on follow‐up had a negative/reactive diagnosis (NR), whereas 37 (51%) turned out to be CIN [CIN‐I–18 (49%) and CIN II and III–19 (51%)]. The significant cytomorphologic differences in the ASC‐H category with a CIN follow‐up (compared with an NR follow‐up) were fewer atypical cells, more often discohesive or seen singly, more monomorphic, a higher nuclear‐to‐cytoplasmic (N/C) ratio, greater nuclear hyperchromasia, more coarse, unevenly dispersed chromatin, more prominent nuclear membrane irregularities, lack of nucleoli, chromocenters or nuclear grooves, and lack of an inflammatory background. Careful attention to subtle cytomorphologic characteristics may be helpful for a more definitive subdivision of ASC‐H terminology into a NR and a CIN diagnosis. Diagn. Cytopathol. 2003;28:308–312. © 2003 Wiley‐Liss, Inc.
“ASCUS，排除 HSIL”：细胞学特征、组织学相关性和人乳头瘤病毒检测。
DOI：
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发表时间：
1999
期刊：
Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
影响因子：
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作者：
Sherman,ME;Tabbara,SO;Scott,DR;Kurman,RJ;Glass,AG;Manos,MM;Burk,RD;Rush,BB;Schiffman,M
通讯作者：
Schiffman,M