Journal of Women's Health Care
Open Access
ISSN: 2167-0420
ISSN: 2167-0420
Nandini N.M, Akansha, Geetanjali
Professor, Department of Pathology, JSSAHER, Mysore Department of Pathology, JSSAHER, Mysore Department of Pathology, JSSAHER, Mysore
Scientific Tracks Abstracts: J Women’s Health Care
A decade ago, cervical cancer was the third most common cancer in women worldwide, and it was ranked as the first most common cancer in women in 42 low-resourced countries. Active screening and treatment of women for precancerous lesions, particularly in developing countries, have a very high chance of total elimination of deaths from cervical cancer. Squamous cell abnormalities that can be detected by cervical cytology include ASC-US, atypical squamous cells-high-grade cannot be excluded (ASC-H), lowgrade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial session (HSIL), and invasive squamous cancer. Glandular cell abnormalities include atypical glandular cells (AGC), including endocervical and endometrial cells (not otherwise specified or favour neoplastic), endocervical adenocarcinoma in situ (AIS), and adenocarcinoma. Atypical squamous cells of undetermined significance (ASC-US) are a category of cervical epithelial cell abnormalities described by the Bethesda system for reporting cervical cytology. It refers to abnormal cytologic changes that are suggestive of the squamous intraepithelial lesion (SIL) but are qualitatively and quantitatively less than those of a definitive SIL diagnosis. The clinical significance of ASC-US is based on the fact that this cytology finding is suggestive of a varying degree of SIL. Nearly 10% to 20% of patients with ASC-US prove to have a varying degree of cervical intraepithelial neoplasia (CIN), which are distinctive precursor lesions of cervical squamous cell carcinoma. ASC-US, therefore, represents a mix of squamous epithelial cells at different stages of transitioning from the lowest risk atypia to the worst form of precancer, with some harbouring the potential to revert to normalcy. ASCUS can be noted in infective conditions like hpv infection, candidiasis, and bacterial vaginosis. Reports say that 10-30% of LSIL and HSIL are diagnosed in women with ASCUS lesion who were monitored. ASC-H is a new category included in the Bethesda Classification 2001 under the epithelial cell abnormalities. It includes approximately 5–10% of previous ASC-US cases and mimics of HSIL. Several previous studies have shown that the positive predictive value for detection of high-grade dysplasia in this group is significantly higher than with ASC-US group. Thus identification of the premalignant conditions of cervix has become important so as to prevent it from going to cancer. The other premalignant conditions like LSIL represented by conditions like inflammation, koilocytic atypia, herpes infection, and radiation changes are also important for early diagnosis and treatment. HSIL which is an important premalignant condition of cervix has to be diagnosed early. It has very close differentials like atrophic smear and squamous metaplasia which have to be identified. There are different methods for screening cervical conditions, like conventional pap smear (CPS), manual liquid based cytology (MLBC) VIA and biopsy for confirmation of the diagnosis. The presentation has made an attempt to discuss about the various conditions infective and non-infective which present either as ASCUS or ASC-H and their importance for gynaecologic management according to ASCCP guidelines 2019 ,which emphasize on the diagnosis of the various conditions so as to decide the management of these conditions Key words: ASCUS, ASC-H, LSIL, HSIL, Cervical cancer
Dr Nandini N. M, Professor, JSS Medical College, Mysore, is attached as a teaching faculty from the past 25 years in the department of pathology . She has worked in the field of cytology of cervix and breast. She has attended many national and international conferences in countries like U.K, USA, Singapore and Netherland. She has worked on liquid based cytology, cell block technique and has come up with indegenious methods. She has severeal publications and books to her credit written on cervical and breast cancer.