Journal of Isfahan Medical School

Journal of Isfahan Medical School

The Frequency of ASC-US, ASC-H, LSIL and HSIL in Pap Smear Tests, Alzahra Hospital, Isfahan, Iran, 2008-2014

Document Type : Original Article (s)

Authors
Azar Baradaran 1
Mohsen Fazilat 2
Noushin Afshar-Moghaddam 1
Ali Mehrabi-Koushki 3
1 Associate Professor, Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Student of Medicine, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
3 Epidemiologist, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: Atypical squamous cells of undetermined significance (ASC-US), atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H), low-grade and high-grade squamous intraepithelial lesion (LSIL and HSIL) are among epithelial cell abnormalities reported on Pap smear test. This study aimed to determine the frequency of ASC-US, ASC-H, LSIL and HSIL on Pap smear reports in the main educational hospital of Isfahan city, Iran.Methods: In this cross-sectional study, reports of ASC-US, ASC-H, LSIL, and HSIL on Pap smear test during 2008 to 2014 were extracted from the pathology archive of Alzahra Hospital. Demographic data of the patients were also extracted from the same archive. Data were analyzed using SPSS software. Descriptive statistics was used to determine the frequency of abnormalities.Findings: We found 46 reports of ASC-US, ASC-H, LSIL, and HSIL among 10754 Pap smear reports in the study time period. Of these, 36 (78.3%), 6 (13%), 3 (6.5%), and 1 (2.2%) were ASC-US, ASC-H, LSIL, and HSIL, respectively. The highest frequency of these epithelial cell abnormalities was reported in 2008 and 2009.Conclusion: Findings of this study show a low frequency of ASC-US, ASC-H, LSIL, and HSIL reports on Pap smear tests in the main educational hospital of Isfahan city. However, these statistics cannot be an exact representative of the frequency of these conditions throughout Isfahan Province. To determine the frequency of these epithelial cell abnormalities on Pap smear tests in Isfahan province, further studies on larger populations are necessary.
Keywords
Pap smear
Atypical squamous cells of undetermined significance (ASC-US)
Atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H)
Low-grade squamous intraepithelial lesion (LSIL)
High-grade squamous intraepithelial lesi
  1. Rosai J. Rosai and Ackerman's surgical Pathology. 10th ed. Philadelphia, PA: Mosby; 2011.
  2. Sherman ME, Kurman RJ. Intraepithelial carcinoma of the cervix: reflections on half a century of progress. Cancer 1998; 83(11): 2243-6.
  3. Vooijs PG, Elias A, van der Graaf Y, Veling S. Relationship between the diagnosis of epithelial abnormalities and the composition of cervical smears. Acta Cytol 1985; 29(3): 323-8.
  4. Willett GD, Kurman RJ, Reid R, Greenberg M, Jenson AB, Lorincz AT. Correlation of the histologic appearance of intraepithelial neoplasia of the cervix with human papillomavirus types. Emphasis on low grade lesions including so-called flat condyloma. Int J Gynecol Pathol 1989; 8(1): 18-25.
  5. Nobbenhuis MA, Walboomers JM, Helmerhorst TJ, Rozendaal L, Remmink AJ, Risse EK, et al. Relation of human papillomavirus status to cervical lesions and consequences for cervical-cancer screening: a prospective study. Lancet 1999; 354(9172): 20-5.
  6. Trevathan E, Layde P, Webster LA, Adams JB, Benigno BB, Ory H. Cigarette smoking and dysplasia and carcinoma in situ of the uterine cervix. JAMA 1983; 250(4): 499-502.
  7. Montz FJ, Monk BJ, Fowler JM, Nguyen L. Natural history of the minimally abnormal Papanicolaou smear. Obstet Gynecol 1992; 80(3 Pt 1): 385-8.
  8. Ursin G, Peters RK, Henderson BE, d'Ablaing G, III, Monroe KR, Pike MC. Oral contraceptive use and adenocarcinoma of cervix. Lancet 1994; 344(8934): 1390-4.
  9. Kwasniewska A, Tukendorf A, Semczuk M. Folate deficiency and cervical intraepithelial neoplasia. Eur J Gynaecol Oncol 1997; 18(6): 526-30.
  10. de Vet HC, Knipschild PG, Willebrand D, Schouten HJ, Sturmans F. The effect of beta-carotene on the regression and progression of cervical dysplasia: a clinical experiment. J Clin Epidemiol 1991; 44(3): 273-83.
  11. Papanicolaou GN, Traut HF. The diagnostic value of vaginal smears in carcinoma of the uterus. 1941. Arch Pathol Lab Med 1997; 121(3): 211-24.
  12. Richart RM. Influence of diagnostic and therapeutic procedures on the distribution of cervical intraepithelial neoplasia. Cancer 1966; 19(11): 1635-8.
  13. Aggarwal P. Cervical cancer: Can it be prevented? World J Clin Oncol 2014; 5(4): 775-80.
  14. The 1988 Bethesda System for reporting cervical/vaginal cytological diagnoses. National Cancer Institute Workshop. JAMA 1989; 262(7): 931-4.
  15. Smith JH. Bethesda 2001. Cytopathology 2002; 13(1): 4-10.
  16. Ehdaeevand F, Neeknejad MT, Aminisani N, Chinifroush M. Cervix dysplasia in 5000 pap smears in Ardabil. J Ardabil Univ Med Sci 2005, 5(1): 22-5. [In Persian].
  17. Almasi Nokiani F, Akbari H. Prevalence of invasive and pre-invasive cervical lesions in Kermanshah (2003-2007). J Qazvin Univ Med Sci 2009; 13(1): 42-8. [In Persian].
  18. Mao C, Balasubramanian A, Koutsky LA. Should liquid-based cytology be repeated at the time of colposcopy? J Low Genit Tract Dis 9:82-8 2005.
  19. Oncins R, Fuente C, Najar M. Descriptive study of cervical intraepithelial neoplasia grade III (CIN III) cases in the area of the hospital of Barbastro. Aten Primaria 2001; 28(7): 457-62. [In Spanish].
Journal of Isfahan Medical School
Volume 33, Issue 353 - Serial Number 353
September and October 2015
Pages 1641-1648

  • Receive Date 24 December 2014
  • Accept Date 06 April 2022