Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Clinical Significance of Atypical Squamous Cells of Undetermined Significance in Detecting Preinvasive Cervical Lesions in Post-Menopausal Turkish Women

  • Tokmak, Aytekin (Obstetrics and Gynecology, Medicine, Dr Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Guzel, Ali Irfan (Obstetrics and Gynecology, Medicine, Dr Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Ozgu, Emre (Obstetrics and Gynecology, Medicine, Dr Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Oz, Murat (Obstetrics and Gynecology, Medicine, Dr Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Akbay, Serap (Department of Pathology, Medicine, Dr Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Erkaya, Salim (Obstetrics and Gynecology, Medicine, Dr Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Gungor, Tayfun (Obstetrics and Gynecology, Medicine, Dr Zekai Tahir Burak Women's Health Education and Research Hospital)
  • Published : 2014.08.30
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Abstract

Background: To evaluate the clinical significance of atypical squamous cells of undetermined significance (ASCUS) in PAP test in post-menopausal women and compare with reproductive age women. Materials and Methods: A total of 367 patients who referred to our gynecologic oncology clinic were included to the study between September 2012 and August 2013. Data for 164 post-menopausal (group 1) and 203 pre-menopausal (group 2) women with ASCUS cytology were evaluated retrospectively. Immediate colposcopy and endocervical curettage was performed for both groups and conization for all women with a result suggestive of CIN2-3. Histopathological results and demographic features of patients were compared between the two groups. Results: Mean age of the patients was $54.6{\pm}6.5$ years in group 1 and $38{\pm}6.6$ years in group 2. Some 14 (8.5%) of post-menopausal women and 36 (17.7%) of pre-menopausal women were current smokers (p=011). Totals of 38 (23.2%) post-menopausal and 64 (31.5%) pre-menopausal women were assessed for HPV-DNA. High risk HPV was detected in 7 (4.3%) and 21 (10.3%), respectively (p=0.029). Final histopathological results recorded were normal cervix, low grade cervical intra-epithelial neoplasia (CIN 1), and high grade cervical intra-epithelial neoplasia (CIN2-3). In group 1 results were 84.8%, 12.2% and 1.8%, respectively, and in group 2 were 71.9%, 23.2% and 4.9%. There were no cases of micro invasive or invasive cervical carcinoma in either group. Two cases were detected as endometrial carcinoma in the menopausal group (1.2%). Conclusions: In current study we found that preinvasive lesions were statistically significantly higher in pre-menopausal women than post-menopausal women with ASCUS. Cervicitis was more common in menopausal women. Therefore, we think that in case of ASCUS in a post-menopausal woman there is no need for radical management.

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References

  1. Cakmak B, Koseoglu DR (2014). Comparison of cervical cytological screening results between post-menopausal and elderly women. Turk Patoloji Derg, 30, 38-42.
  2. Castle PE, Schiffman M, Herrero R, et al (2005). A prospective study of age trends in cervical human papillomavirus acquisition and persistence in Guanacaste, Costa Rica. J Infect Dis, 191, 1808-16. https://doi.org/10.1086/428779
  3. Filipi K, Xhani A (2014). Assessment of cervical cytological data in Albanian females. Asian Pac J Cancer Prev, 15, 2129-32. https://doi.org/10.7314/APJCP.2014.15.5.2129
  4. Goksedef BP, Akbayir O, Baran SY, et al (2011). Atypical squamous cells of undetermined significance in postmenopausal women: a comparative retrospective analysis. Eur J Obstet Gynecol Reprod Biol, 159, 418-21. https://doi.org/10.1016/j.ejogrb.2011.07.027
  5. Johnston EI, Logani S (2007). Cytologic diagnosis of atypical squamous cells of undetermined significance in perimenopausal and post-menopausalwomen. Lessons leamed from human papilloma virus DNA testing. Cancer, 111, 160-5. https://doi.org/10.1002/cncr.22687
  6. Kececioglu M, Seckin B, Baser E, et al (2013). Cost and effectiveness comparison of immediate colposcopy versus human papillomavirus DNA testing in management of atypical squamous cells of undetermined significance in Turkish women. Asian Pac J Cancer Prev, 14, 511-4. https://doi.org/10.7314/APJCP.2013.14.1.511
  7. Kurman R, Henson D, Herbst A, et al (1994). Interim guidelines for management of abnormal cervical cytology. JAMA, 27, 1866-9.
  8. Parkin DM, Bray F (2006). Chapter 2: The burden of HPVrelated cancers. Vaccine, 24, 3-11. https://doi.org/10.1016/j.vaccine.2005.01.101
  9. Piccoli R, Mandato VD, Lavitola G, et al (2008). Atypical squamous cells and low squamous intraepithelial lesions in post-menopausal women: implications for management. Eur J Obstet Gynecol Reprod Biol, 140, 269-74. https://doi.org/10.1016/j.ejogrb.2008.05.007
  10. Poomtavorn Y, Suwannarurk K, Thaweekul Y, Maireang K. (2011). Risk factors for high-grade cervical intraepithelial neoplasia in patients with atypical squamous cells of undetermined significance (ASC-US) Papanicolaou smears. Asian Pac J Cancer Prev, 12, 235-8.
  11. Rodriguez EF, Reynolds JP, Jenkins SM, et al (2012). Atypical squamous cells of undetermined significance in patients with HPV positive DNA testing and correlation with disease progression by age group - an institutional experience. Int J Clin Exp Pathol, 5, 428-35.
  12. Sangkarat S, Laiwejpithaya S, Rattanachaiyanont M, et al (2014). Performance of Siriraj liquid-based cytology: a single center report concerning over 100,000 samples. Asian Pac J Cancer Prev, 15, 2051-5. https://doi.org/10.7314/APJCP.2014.15.5.2051
  13. Siegel R, Naishadham D, Jemal A (2012). Cancer statistics, 2012. CA Cancer J Clin, 62, 10-29. https://doi.org/10.3322/caac.20138
  14. Solomon D, Schiffman M, Tarone R, ALTS Study Group (2001). Comparison of three management strategies for patients with atypical squamous cells of undetermined significance: baseline results from a randomized trial. J Natl Cancer Inst, 93, 293-9. https://doi.org/10.1093/jnci/93.4.293
  15. Solomon D, Davey D, Kurman R, et al (2002). The 2001 Bethesda System: terminology for reporting results of cervical cytology. JAMA, 287, 2114-9. https://doi.org/10.1001/jama.287.16.2114
  16. Wang JL, Yang YZ, Dong WW, et al (2013). Application of human papillomavirus in screening for cervical cancer and precancerous lesions. Asian Pac J Cancer Prev, 14, 2979-82. https://doi.org/10.7314/APJCP.2013.14.5.2979
  17. Wright TC Jr, Cox JT, Massad LS, Twiggs LB, Wilkinson EJ. (2002). 2001 Consensus Guidelines for the management of women with cervical cytological abnormalities. JAMA, 287, 2120-9. https://doi.org/10.1001/jama.287.16.2120

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  3. ASCUS (Atypical Squamous Cells of Undetermined Significance) in the Cervical Smears of Women from Rural Population of Lucknow West pp.0975-6434, 2019, https://doi.org/10.1007/s13224-018-1160-2