Clinical Significance of Atypical Squamous Cells of Undetermined Significance: Qualifiers as a Guideline of Follow-up Management of ASCUS

Park, C S; Noh, J S; Hwang, J D; Joo, I S; Song, S Y; Bae, D S; Lee, J H

Abstract

OBJECTIVES
To define the clinical significance of qualifying the cytologic diagnosis of ASCUS in an effort to provide management guidelines. Study DESIGN: A total of 362 women with a cytologic diagnosis of ASCUS favoring either a reactive process or squamous intraepithelial lesion (SIL) evaluated by repeated Pap smear, colposcopy-directed biopsy and/or cone biopsy was reviewed retrospectively.
RESULTS
Of the 268 patients who had a cervicovaginal cytologic diagnosis of ASCUS favoring reactive process, 253 (94.4%) had a repeated smear and/or cervical tissue biopsy that was normal. Fifteen (5.6%) of 268 patients had squamous intraepithelial lesion. Of the 79 patients who had a cervicovaginal cytologic diagnosis of ASCUS favoring SIL, 38 (48.1%) had a repeated smear and/or cervical tissue biopsy that was normal. Forty one (51.9%) of 79 patients had SIL or invasive cancer.
CONCLUSION
This study showed that a cytologic diagnosis of ASCUS favoring reactive process was associated with a very low risk that the patient was harboring SIL. But the patient whose initial smear showed ASCUS favoring SIL was associated with a relatively high risk that the patient was harboring SIL (p<0.05). So the patient whose smear showed ASCUS favoring SIL requires further active management even in the presence of a normal repeated Pap smear.