C. Vasiliu, S.E. Albu, C. Alexandrescu, M. Carsote, A. Bădănoiu, C. Gorgoi
Rezumat: Introduction. Atypical squamous cells cannot exclude
high grade squamous intraepithelial lesion (ASC-H), a
recognized category in the 2001 Bethesda Nomenclature
System for cervical cytology. Limited follow-up data
are available on patients with this cervical cytology
results. ASC-H is a large umbrella of citologic anomalies
that can hide a severe cervical lesion or an atrofic or an
inflammatory modification with no special signification.
Further investigation procedures are necesary to decide
the diagnosis and the therapeutic management.
Methodes. A retrospective evaluation of data from a total
of 1972 Pap tests that were performed at our institution
from 1.01.2013 - 1.01.2015, but only 87 (4.4%) of these
cases were diagnosed as ASC-H. All these 87 cases were
reffered to colposcopy. According to the colposcopic
result, we decided the further management. Biopsy was
performed in 42 cases. The type of biopsy is presented in
the article. Results. The age of the patients was between
21 and 73 years old. HPV DNA was tested in 11 cases;
HPV 16 was present in 5 cases, HPV 18 in one case and
in 5 cases more than one type of HPV were found. After
the colposcopic examination, 45 cases were considered
benign and after a topic treatment, they were reevaluated
at a 6-month interval. Biopsy was performed in 42 cases
and the histologic results identified: cervical neoplasia
(30%), scuamous carcinomas (12%), inflammation,
atrophy, endocervical hyperplasia, squamous metaplasia,
hyperkeratosis, condiloma and normal histology in other
cases (48%). The concordance between colposcopy and
histology was 69% and if we take into account the 4 cases
of unsatisfactory colposcopy where the biopsy was positive,
the concordance is 78.5%. Conclusions.The cytological
diagnosis of ASC-H is strongly associated with dysplasia
of any grade and may lead to the diagnosis of cervical
cancer as well. That is why these cases should be evaluated
by colposcopy and by cervical biopsy where colposcopy
indicates so. The type of biopsy will be chosen according
to age and to extending and gravity of the lesion. Cuvinte cheie: cervical citology ASC-H, DNAHPV
test, colposcopy, biopsy.