Introduction/Background Diagnostic workup and prevention of overtreatment of the patients diagnosed with a cytological diagnosis of atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H) may be challenging in clinical practice. We aimed to evaluate the histological outcome of ASC-H cytology and to evaluate the accuracy of colposcopy in predicting both low grade and high-grade histological lesions.
Methodology A retrospective study was conducted from January 2014 to December 2022, in Akdeniz University Faculty of Medicine Hospital. We selected all cases with ASC-H diagnosed by cervical cytological examinations. Demographic characteristics, colposcopic findings, diagnostic procedures, and histological outcomes were analyzed using SPSS, version 23.0
Results Seventy-six patients were included in this study. The mean age at diagnosis was 47.2 years (range, 25 to 77 years). The overall incidence of cervical dysplasia of any grade was 83.6% (n = 56). The incidence of high-grade lesions was 38,2% (n = 29) (including 5 cases of in situ carcinoma). A high-grade lesion was detected in only three of the patients who underwent endocervical curettage. HPV test was positive in 28,9% (n:22) cases, and negative in 32,9% (n:25) cases. Colpo-histologic concordance was 82,9.% and 75,8% for grade 1-lower lesions and high grade lesions, respectively. The sensitivity, specificity, positive predicted value (PPV) and false negative ratio was%75,8, 82,9, %, 47,5%, and 14,8%, respectively.
Conclusion ASC-H is associated with high-grade histological lesions. Colposcopy, when performed by expert clinicians, has great accuracy in detecting both low and high-grade lesions. Therefore, patients who do not have an indication for excisional treatment and who desire fertility can be followed up with colposcopy.
Disclosures The authors have no conflict of interest.
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