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

Onuma,Toshimichi; Tajima,Kimihisa; Sato,Kumiko; Hattori,Katsushige; Fukuda,Shin; Tsuji,Takahiro; Yoshida,Yoshio

doi:10.3892/mco.2017.1443

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

Authors:
- Toshimichi Onuma
- Kimihisa Tajima
- Kumiko Sato
- Katsushige Hattori
- Shin Fukuda
- Takahiro Tsuji
- Yoshio Yoshida
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Affiliations: Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, Fukui 910‑1193, Japan, Department of Obstetrics and Gynecology, Fukui Red Cross Hospital, Fukui 918‑8501, Japan
Published online on: October 4, 2017 https://doi.org/10.3892/mco.2017.1443
Pages: 1032-1038

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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.

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