PAP SMEAR WITH ATYPICAL SQUAMOUS CELLS OF UNDETERMINED SIGNIFICANCE

Objective: This study was conducted to obtain histological results in cases with atypical squamous cells of undetermined significance (ASCUS) found on Papanicolaou (Pap) smears. Methods: We reviewed cases with ASCUS found in cervical cytology from March 1999 through February 2002 of patients who attended Imam Khomeini or Mehr General Hospitals (n = 104). Except for one patient in whom cervical biopsy was done without colposcopy, the remaining 103 had biopsy under direct colposcopy. Results: Histological examination revealed 28.8% squamous intraepithelial lesion (SIL) (14 lowgrade SIL [LSIL] and 16 high-grade SIL [HSIL]), 1 invasive carcinoma, and 1 endometrial carcinoma. A Pap smear was repeated in 60 women with ASCUS before colposcopy and was normal in 7 (11.7%) cases, revealed ASCUS in 45 (75%) cases, and SIL in 8 (13.3%) cases including 6 LSIL and 2 HSIL. Among the 7 normal cases after the repeated Pap smear, histological examinations showed 2 cases of LSIL. In colposcopic examinations of 103 cases, 22 (21.4%) were diagnosed as normal, while one case had a histological report of LSIL. Conclusion: Since the cytopathologists’ reports do not differentiate between ASCUS and atypical squamous cells seen in HSIL, to detect any underlying SIL, it seems that immediate colposcopy and direct biopsy are more appropriate methods for managing cases with ASCUS.