Titre du document / Document title

Atypical squamous cells of undetermined significance in women over 55 : Comparison with the general population and implications for management

Auteur(s) / Author(s)

RADER A. E. ⁽¹⁾ ; ROSE P. G. ⁽²⁾ ; RODRIGUEZ M. ⁽²⁾ ; MANSBACHER S. ⁽¹⁾ ; PITLIK D. ⁽¹⁾ ; ABDUL-KARIM F. W. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Pathology, University Hospitals of Cleveland, Case Western Reserve University School of Medicine, Cleveland, Ohio, ETATS-UNIS
⁽²⁾ Department of Reproductive Biology, University Hospitals of Cleveland, Case Western Reserve University School of Medicine, Cleveland, Ohio, ETATS-UNIS

Résumé / Abstract

OBJECTIVE: To determine the significance of atypical squamous cells of undetermined significance (ASCUS) in patients 55 years or older. STUDY DESIGN: From January 1994, to January 1997, 8,175 cervicovaginal smears were obtained from patients 55 years or older (mean age, 64.8; range, 56-84) at University Hospitals of Cleveland. Ninety-six of these patients were diagnosed with ASCUS only or ASCUS with a qualifying statement on the smear. Patient records, follow-up cervicovaginal smears and biopsies were reviewed for a period of one to four years following the diagnosis of ASCUS. RESULTS: The incidence of ASCUS only or ASCUS with a qualifying statement for patients 55 years or older was 1.8%. The ASCUS:SIL ratio was 2.6:1. An estrogen stimulation test was recommended in two cases. Women older than 55 with ASCUS were three times more likely to be receiving hormonal replacement therapy than similar-aged women with normal cervicovaginal smears. Follow-up cervicovaginal smears or biopsies were obtained on 93 (80 cervicovaginal smears, 13 biopsies). The results were the following : LSIL (13), squamous carcinoma in situ (1) and ASCUS (53); the remainder of the cases were normal. In the patients who received a second diagnosis of ASCUS, follow-up cervicovaginal smears or biopsies revealed low grade dysplasia in six. CONCLUSION: Although the incidence of ASCUS and the frequency of underlying dysplasia is lower in postmenopausal women than the general population, there is still a real risk that a postmenopausal woman with ASCUS has underlying intraepithelial neoplasia. Therefore, these patients should be managed as is the general population.

Revue / Journal Title

Acta cytologica   ISSN 0001-5547   CODEN ACYTAN 

Source / Source

1999, vol. 43, n^o3, pp. 357-362 (23 ref.)

Langue / Language

Anglais

Editeur / Publisher

Science Printers and Publishers, St. Louis, MO, ETATS-UNIS  (1957) (Revue)

Mots-clés anglais / English Keywords

Cervical dysplasia ; Medical screening ; Cervical smear ; Cytopathology ; Pathology ; Epithelial cell ; Atypical ; Age ; Comparative study ; Human ; Female ; Postmenopause ; Premalignant lesion ; Female genital diseases ; Uterine cervix diseases ;

Mots-clés français / French Keywords

Dysplasie col utérus ; Dépistage ; Frottis cervical ; Cytopathologie ; Anatomopathologie ; Cellule épithéliale ; Atypique ; Age ; Etude comparative ; Homme ; Femelle ; Postménopause ; Lésion précancéreuse ; Cellule épidermoïde atypique de signification indéterminée ; Appareil génital femelle pathologie ; Col utérus pathologie ;

Mots-clés espagnols / Spanish Keywords

Displasia cuello útero ; Descubrimiento ; Frotis cervical ; Citopatología ; Anatomía patológica ; Célula epitelial ; Atípico ; Edad ; Estudio comparativo ; Hombre ; Hembra ; Postmenopausia ; Lesión precancerosa ; Aparato genital hembra patología ; Cuello útero patología ;

Localisation / Location

INIST-CNRS, Cote INIST : 10515, 35400008463367.0050