Department of Pathology, Division of Cytopathology, University of Massachusetts Medical School, Worcester, Massachusetts.
Cancer Cytopathol. 2014 Feb;122(2):123-7. doi: 10.1002/cncy.21346. Epub 2013 Aug 26.
Pap test (PT) interpretations of low-grade squamous intraepithelial lesion (LSIL), cannot exclude high-grade squamous intraepithelial lesion (HSIL), or LSIL-H, are used in many laboratories; however monitoring its usage for quality assurance purposes is understudied.
PTs from 2005 to 2010 were collected, and yearly frequencies of LSIL, HSIL, LSIL-H, and atypical squamous cells, cannot exclude HSIL (ASC-H) as a function of total PTs and total squamous intraepithelial lesions (SILs) were calculated. Two-year risk of cervical intraepithelial neoplasia 2 (CIN2) or worse (CIN2+) and CIN 3 or worse (CIN3+) was calculated.
A total of 352,220 PTs were identified including 17,301 abnormal PTs. LSIL-H usage increased from 2005 to 2010 (from 0.28% of total PTs in 2005 to 0.61% in 2010, P < .01; from 5.8% of total SILs in 2005 to 12% in 2010, P < .001). HSIL usage decreased significantly from 2005 to 2010 (from 0.7% of total PTs in 2005 to 0.48% in 2010, P = .048; from 14.5% of total SILs in 2005 to 9.5% in 2010, P < .01). Usage of LSIL and ASC-H did not change. Two-year risk of CIN2+ and CIN3+ for HSIL increased significantly from 2005 to 2010 (P < .01). Two-year risk of CIN2+ and CIN3+ for LSIL-H did not change significantly from 2005 to 2010.
The frequency of LSIL-H interpretations is significantly increasing at our institution, with a significant decrease in HSIL interpretations over the same period. Two-year risk of CIN2+ and CIN3+ for HSIL increased significantly as usage of LSIL-H increased and that of HSIL decreased. Laboratories using LSIL-H may benefit from monitoring its frequency to ensure its appropriate use. Cancer (Cancer Cytopathol) 2014;122:123-7. © 2013 American Cancer Society.
巴氏试验（PT）对低度鳞状上皮内病变（LSIL）、不能排除高级别鳞状上皮内病变（HSIL）或 LSIL-H 的解释，在许多实验室中都有使用；然而，对其使用情况进行质量保证监测的研究还很少。
收集了 2005 年至 2010 年的 PT 数据，计算了 LSIL、HSIL、LSIL-H 和非典型鳞状细胞、不能排除 HSIL（ASC-H）作为总 PT 和总鳞状上皮内病变（SILs）的函数的年度频率。计算了两年内宫颈上皮内瘤变 2 级或更高级别（CIN2+）和 CIN3 或更高级别（CIN3+）的风险。
共确定了 352220 例 PT，其中 17301 例为异常 PT。LSIL-H 的使用从 2005 年到 2010 年有所增加（总 PT 中的比例从 2005 年的 0.28%增加到 2010 年的 0.61%，P<.01；总 SILs 中的比例从 2005 年的 5.8%增加到 2010 年的 12%，P<.001）。HSIL 的使用从 2005 年到 2010 年显著下降（总 PT 中的比例从 2005 年的 0.7%下降到 2010 年的 0.48%，P=.048；总 SILs 中的比例从 2005 年的 14.5%下降到 2010 年的 9.5%，P<.01）。LSIL 和 ASC-H 的使用没有变化。HSIL 的两年内 CIN2+和 CIN3+的风险从 2005 年到 2010 年显著增加（P<.01）。LSIL-H 的两年内 CIN2+和 CIN3+的风险从 2005 年到 2010 年没有显著变化。
在我们的机构中，LSIL-H 解释的频率显著增加，而同期 HSIL 解释的频率显著下降。随着 LSIL-H 的使用增加和 HSIL 的使用减少，HSIL 的两年内 CIN2+和 CIN3+的风险显著增加。使用 LSIL-H 的实验室可能受益于监测其频率，以确保其合理使用。癌症（癌症细胞病理学）2014；122:123-7。© 2013 美国癌症协会。
