The Korean Journal of Cytopathology 13(1): 14-20, 2002

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13 1 The Korean Journal of Cytopathology 13(1): 14-20, 2002

: ASCUS 1941 Papanicolaou. The Bethesda System(TBS) 1) 1988, atypical squamous cells of undetermined significance(ascus), low-grade squamous intraepithelial lesion(lsil), high-grade squamous intraepithelial lesion(hsil), squamous cell carcinoma. ASCUS SIL, SIL ASCUS. 2) ASCUS SIL, 3-6) TBS ASCUS (ASCUS, favor reactive) SIL (ASCUS, favor SIL). 7) ASCUS, SIL ASCUS ASCUS SIL. 8-10) LSIL 11,12) HSIL ASCUS 13) ASCUS SIL HSIL ASCUS(ASCUS, R/O HSIL), 2001 TBS ASCUS ASC-US(atypical squamous cells of undetermined significance) ASC-H(atypical squamous cells cannot exclude HSIL). ASCUS, R/O HSIL HSIL HPV DNA test ASCUS, not otherwise specified(nos) ASCUS. ASCUS, R/O HSIL,. 1995 99 ASCUS, R/O HSIL ASCUS, R/O SIL 275 ASCUS, R/O LSIL 174 HSIL 101. 101,.. 101 87, 47 hybrid capture (Hybrid Capture II, Digene, USA) HPV DNA. HPV DNA. 2000 1 3 ASCUS, NOS 89. Chi square p <0.05. ASCUS, R/O HSIL,,,,. 35.6% 36.6%,,, (Table 1).,,.

/ 13 / 1 / 2002.. (Fig. 2), (Fig. 3),. HSIL (Fig. 4), (Fig. 5). (Fig. 1) 87, LSIL, HSIL, 39.1%, 4.6%, 54%, 2.3%,. ASCUS, NOS 89, LSIL, HSIL 69.7%, 15.7%, 14.6% ASCUS, R/O HSIL HSIL (p =0.000)(Table 2).

: ASCUS 47 ASCUS, R/O HSIL 60 ASCUS, reactive HPV DNA, 57.4% 60.0%. 1988 TBS -Pap class I-IV, cervical intraepithelial lesion (CIN) I-III, dysplasia -. TBS atypical sqaumous cells of undetermined significance " SIL ",

/ 13 / 1 / 2002,. 1991 Bethesda Workshop ASCUS SIL. 7) ASCUS, ASCUS SIL. Sidawy 3) "atypia" 88 ASCUS, 5.2% 61.3% SIL ASCUS SIL. Williams 5) ASCUS 28, 58% SIL 49% LSIL. ASCUS LSIL. Lachman 6) Carvallo-Calcanese ASCUS 560 36.2% 203 SIL, 109 LSIL, 94 HSIL. ASCUS, NOS 30.3% SIL HSIL. ASCUS SIL, 14) ASCUS favor SIL favor reactive. TBS ASCUS SIL, ASCUS. Kline Davey 8) ASCUS favor reactive, favor dysplasia unqualified SIL, SIL 29.5%, 46.5%, 26.2% ASCUS, favor dysplasia. Collins 9) ASCUS, ASCUS favor reactive, ASCUS favor SIL, LSIL 435. SIL ASCUS, ASCUS favor reactive, ASCUS favor SIL, LSIL 10%, 28%, 36%, 55%, ASCUS favor reactive ASCUS ASCUS favor SIL SIL. ASCUS, favor SIL HSIL 15% ASCUS, reactive ASCUS HSIL, ASCUS, favor SIL LSIL. Vlahos 10) SIL ASCUS ASCUS SIL41.1% 22.3%, HSIL SIL ASCUS 9.7. SIL ASCUS. ASCUS SIL, SIL ASCUS LSIL. LSIL 11,12) HSIL, SIL ASCUS HSIL, HSIL ASCUS 13), HSIL HSIL ASCUS. ChangChien 15) ASCUS HISL HSIL 77.0% 3.8%, Genest 16) ASCUS favor reactive, not otherwise specified, favor SIL, favor HSIL ASCUS, favor HSIL HSIL.

: ASCUS ASCUS, NOS ASCUS, R/O HSIL HSIL 56.3% 14.6%. ASCUS, R/O HSIL, HSIL ASCUS. ASCUS, favor SIL ASCUS, R/O HSIL TBS, ASCUS SIL. Morin 17) ASCUS 36 LSIL HSIL, LSIL, HSIL,,,. Sheils Wilbur 18) ASCUS SIL, HSIL, Montes 19) HSIL. HSIL. ASCUS, R/O HSIL Sherman 20),,,, 21.3% 17.3%.,, Sherman 20), 36.6% 35.6%.. Sheils Wilbur 18) Montes 19) 18.8%.,,. ASCUS, NOS ASCUS, R/O HSIL HPV DNA, HPV HPV. 1995 99 HSIL 101. ASCUS, R/O HSIL ASCUS, NOS HPV DNA test ASCUS. ASCUS, R/O HSIL,,,,, 35.6% 36.6%. ASCUS, R/O HSIL ASCUS, NOS HSIL. ASCUSHSIL.

/ 13 / 1 / 2002 1. NCI Workshop: The 1988 Bethesda System for reporting cervical/vaginal cytological diagnosis. JAMA 262:931-934, 1989 2. Kurman RJ, Solomon D: The Bethesda System for Reporting Cervical/Vaginal Cytologic Diagnoses. New York, Springer-Verlag, 1994, pp30-34 3. Sidawy MK, Tabbara SO: Reactive change and atypical squamous cells of undetermined significance in Papanicolaou smears: A cytohistologic correlation. Diagn Cytopathol 9:423-429,1993 4. Howell LP, Davis RL: Follow-up of Papanicolaou smears diagnosed as atypical squamous cells of undetermined significance. Diagn Cytopathol 14:20-24,1996 5. Williams ML, Rimm DL, Pedigo MA, Frable WJ: Atypical squamous cells of undeterined significance: Correlative histologic and follow-up studies from an academic medical center. Diagn Cytopathol 16:1-7,1997 6. Lachman MF, Cavallo-Calcanese C: Qualification of atypical squamous cells of undetermined significance in an independent laboratory: Is it useful or significant? Am J Obstet Gynecol 179:421-429,1998 7. National Cancer Institute Workshop. The Bethesda system for reporting cervical/vaginal cytologic diagnoses:report of the 1991 Bethesda Workshop. JAMA 267:1892,1992 8. Kline MJ, Davey DD: Atypical squamous cells of undetermined significance qualified: A follow-up study. Diagn Cytopathol 14:380-384,1996 9. Collins LC, Wang HH, Abu-Jawdeh AM: Qualifiers of atypical squamous cells of undetermined significance help in patient management. Mod Pathol 9:677-681,1996 10. Vlahos NP, Dragisic KG, Wallach EE, Burroughs FH, Fluck S, Rosenthal DL: Clinical significance of the qualification of atypical squamous cells of undetermined significance: An analysis on the basis of histologic diagnoses. Am J Obstet Gynecol 182:885-890,2000 11. Lee SS, Collins RJ, Pun TC, Cheng DK, Ngan HY: Conservative treatment of low grade squamous intraepithelial lesions (LSIL) of the cervix. Int J Gynecol Pathol 60:35-40,1998 12. Falls RK: Spontaneous resolution rate of grade 1 cervical intraepithelial neoplasia in a private practice population. Am J Obstet Gynecol 181:278-282,1999 13. Kinney WK, Manos MM, Hurley LB, Ransley JE: Where's the high-grade cervical neoplasia? The importance of minimally abnormal Papanicolaou diagnoses. Obstet Gynecol 91:973-976,1998 14. Yang M, Zachariah S: ASCUS on cervical cytologic smears: Clinical significance. J Reprod Med 42:329-331,1997 15. ChangChien CC, Lin H, Eng HL, Chang WK: Clinical implication of atypical squamous cells of undetermined significance with or without favoring high-grade squamous intraepithelial lesion on cervical smear (abstract). Changgeng Yi Xue Za Ahi 22:579-585,1999 16. Genest DR, Dean B, Lee KR, Sheets E, Crum CP, Cibas ES: Qualifying the cytologic diagnosis of "atypical squamous cells of undetermined significance" affects the predictive value of a squamous intraepithelial lesion on subsequent biopsy. Arch Pathol Lab Med 122:338-341,1998 17. Morin C, Bairati I, Bouchard C, et al.: Cytologic predictors of cervical intraepithelial neoplasia in women with an ASCUS pap smear. Acta Cytol 44:576-586,2000 18. Sheils LA, Wilbur DC: Atypical squamous cells of undetermined significance: Stratification of the association with, or progression to, squamous intraepithelial lesions based on morphologic subcategorization. Acta Cytol 41:1065-1072,1997 19. Montes MA, Cibas ES, DiNixco SA, Lee KR: Cytologic characteristics of abnormal cells in prior "normal" cervical/vaginal Papanicolaou smears from women with a high grade squamous intraepithelial lesion. Cancer 87:56-59,1999 20. Sherman ME, Tabbara SO, Scott DR, et al.: "ASCUS, R/O HSIL": Cytologic features, histologic correlates, and human papillomavirus detection. Mod Pathol 12:335-343,1999