Auger M, Charbonneau M, Arseneau J
Department of Pathology, Royal Victoria Hospital, McGill University, Montreal, QC, Canada.
Acta Cytol. 1997 Nov-Dec;41(6):1671-5. doi: 10.1159/000333166.
To evaluate the significance of atypical squamous cells of undetermined significance (ASCUS) by correlating the histologic findings following a diagnosis of ASCUS on a cervical cytologic smear.
Eighty-four smears that had been called ASCUS over a five-month period and that had corresponding histologic material were reviewed independently. Only 52 of the 84 cases on which a consensus was reached were retained for the current study.
The breakdown of the follow-up histologic diagnoses was as follows: 28 cases (54%) were negative (without squamous intraepithelial lesions [SIL]); 22 cases (42%) showed SILs, of which 14 (27%) were low grade, 5 (10%) were high grade and 3 (5%) had SILs that could not be further classified because of fragmentation of the endocervical curettings. Finally, two cases (4%) proved to be invasive cervical carcinoma on histology despite smears that were satisfactory and not limited by the quantity or quality of material; in these the discrepancy was attributed to sampling error.
Patients whose cervical cytologic smears fall into the category of ASCUS may, on follow-up, exhibit a wide spectrum of findings, ranging from no pathologic abnormality to frequent SIL and even to invasive carcinoma in rare instances. A diagnosis of ASCUS on smears warrants careful follow-up and investigation.
通过将宫颈细胞学涂片诊断为意义不明确的非典型鳞状细胞（ASCUS）后的组织学检查结果进行关联，评估ASCUS的意义。
对在五个月期间被诊断为ASCUS且有相应组织学材料的84份涂片进行独立回顾。84例中仅52例达成共识的病例被纳入本研究。
后续组织学诊断分类如下：28例（54%）为阴性（无鳞状上皮内病变[SIL]）；22例（42%）显示有SIL，其中14例（27%）为低级别，5例（10%）为高级别，3例（5%）因宫颈刮出物破碎无法进一步分类。最后，2例（4%）尽管涂片质量令人满意且不受材料数量或质量限制，但组织学检查证实为浸润性宫颈癌；在这些病例中，差异归因于取样误差。
宫颈细胞学涂片诊断为ASCUS的患者在随访中可能会出现广泛的检查结果，从无病理异常到频繁出现SIL，甚至在罕见情况下出现浸润癌。涂片诊断为ASCUS需要仔细随访和检查。
