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. 2017 Dec;7(6):1032-1038.
doi: 10.3892/mco.2017.1443. Epub 2017 Oct 4.

Clinical significance of atypical squamous cells of undetermined significance after treatment for cervical intraepithelial grade 3 neoplasia: A retrospective single-center cohort study

Toshimichi Onuma  1   2 , Kimihisa Tajima  2 , Kumiko Sato  2 , Katsushige Hattori  2 , Shin Fukuda  2 , Takahiro Tsuji  2 , Yoshio Yoshida  1
Affiliations

Clinical significance of atypical squamous cells of undetermined significance after treatment for cervical intraepithelial grade 3 neoplasia: A retrospective single-center cohort study

Toshimichi Onuma et al. Mol Clin Oncol. 2017 Dec.

Abstract

The aim of the present study was to evaluate the clinical significance of atypical squamous cells of undetermined significance (ASC-US) following cervical conization for cervical intraepithelial neoplasia (CIN) grade 3. This study was a retrospective cohort analysis. The medical records of women treated with conization for CIN 2-3 were reviewed and 142 patients with CIN 3 who had been diagnosed using the conization specimens were selected. The mean follow-up period after conization was 41.8 months. Cytological abnormalities after conization were observed in 19.0% of the patients and consisted of ASC-US (13.4%) and worse than low-grade squamous intraepithelial lesion (LSIL; 5.6%). Recurrence was defined as a diagnosis worse than CIN 2, and the recurrence rate was 29.6% among patients with abnormal cytology. The recurrence rate was 15.7% in the ASC-US group and 71.4% in the worse than LSIL group. There was no significant difference in the time of initial identification of abnormal cytology after treatment between the worse than LSIL and the ASC-US groups (P=0.054). However, the ASC-US group had a significantly better cumulative recurrence-free rate compared with the worse than LSIL group (P<0.05). Women with ASC-US following treatment for CIN appear to be at a relatively high risk. Regarding the risk stratification of women following treatment for CIN, if surveillance cytology shows ASC-US, immediate colposcopy is recommended, along with long-term follow-up.

Keywords: atypical squamous cells of undetermined significance; cervical intraepithelial neoplasia grade 3; conization; follow-up cytology; recurrence.

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Figures

Figure 1.
Figure 1.
Cumulative recurrence-free rate. Kaplan-Meier survival curves with log-rank tests, with patient status at the time of the last follow-up visit, were used to compare the cumulative recurrence-free rates among the normal, ASC-US and worse than LSIL groups. NILM, negative for intraepithelial lesion or malignancy; ASC-US, atypical squamous cells of undetermined significance; LSIL, low-grade squamous intraepithelial lesion.
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