Cytohistological Correlation of ASC-H and HSIL in Samples Submitted During a Five-Year Period

Abstract

The classification of cytological abnormalities has been based on the Bethesda system. Since its implementation in 1988, several revisions have been made to incorporate new technical and scientific findings. The objective of this study was to evaluate the clinical importance and the histological result of cervical cytologies reported as HSIL, in addition to those classified as ASC-H, determining their prediction of histological lesions, mainly high-grade, in subsequent biopsies. During the period from January 2015 to December 2019, 36,984 cervical-vaginal cytology studies were performed, referred to our department. Of these, 43 (0.12%) were classified as ASC-H and 76 as HSIL (0.20%). Nine cases were excluded because they did not have a histopathological study within the period of one year after the cytopathological study and 2 cases in which the sample for the histopathological study was insufficient. Finally, 38 cases of ASC-H and 70 cases of HSIL met the inclusion criteria and constituted the total study population, a total of 108 cases. In our study 55.3% of cases of ASC-H corresponded to a final diagnosis of a high-grade lesion and 84.3% for cases diagnosed with HSIL cytology, in which a histological diagnosis of a high-grade lesion has been demonstrated. The concordance values for the HSIL and ASC-H diagnoses demonstrated in this work correspond to those cited in previous studies and recommendation guidelines, and these data justify the study of these patients. This demonstrates the fundamental importance of diagnostic cytology in the population screening of cervical cancer