Atypical squamous cells (ASC) in The uterine cytology with histologic outcome in Chiangkham Hospital: Phayao Province

Abstract

 Introduction: Cervical cancer is reported to be the second highest form of Thai woman cancers. The Pap test has proved to be an effective method for screening abnormal cervical cells. The Bethesda 2001 system (TBS) is the guideline for reporting cervical cytology. The interpretation of atypical squamous cells in problematic in making definitive diagnosis in many cytological laboratories as found in our lab. Chiangkham Hospital is a small provincial government hospital with no cytopathologist. There are one cytological screener and cytotechnician. However the cytological and pathological correlation should be performed for the definitive diagnosis. Material and method: The retrospective descriptive study was performed from the cytological laboratory in Chiangkham Hospital, Phayao Province. The specimen (conventional Pap smear) were collected by well trained nurses and gynaecologist during October 1^st, 2008 – September 30^th, 2012. Women with atypical squamous cells were followed up by performing the colposcopy examination, and cervical biopsied or LEEP are obtained for pathological study. The cytopathological correlation were analysed. Objective: To study the investigation of cytological results and pathological outcome in the women with Atypical Squamous Cells (ASC) in Chiangkham Hospital. Results: A total of 59,008 cases of smears were examined and 984 (1.66%) showed cytologic abnormalities. The 126 women with atypical squamous cells were analysed. It was found that 73 cases of ASC-H shown 39.73% of HSIL, and 1.37% of Squamous cell carcinoma. Fifty-three cases of ASC-US were diagnosed as 9.43% of HSIL and 1.89% found Adenocarcinoma in situ. Conclusions: Many cases with the diagnostic of ASC-H show a biopsy proven CIN (93.15%) and ASC-US approved to be CIN (90.57%). The interpretation as ASC-US and ASC-H should be more attention for proper investigation and management. Immediate colposcopy examination is recommended in women with high risk factors in cervical cancer.