Squamous Cell Atypia Suggesting High-grade Lesions: Correlation of Morphological Data, HPV Test Results and Follow-up

Abstract

Background: Squamous cell atypia suggesting high-grade lesion (ASCH) is a cytological lesion, related to a high-grade lesion. Guidelines recommend performing a colposcopy in these cases, without HPV testing. Objective: Here we sought to determine the value of the HPV test in ASCH cases and to correlate morphological data, the HPV test results, and the follow-up. Methods: Ninety-six patients were diagnosed with ASCH using liquid-based cytology (Thin-Prep®). Hybrid Capture II was the HPV test used. The patients were followed up for 6 to 48 months (mean 24 months). The following cytological data were included: isolated cells; dyskeratosis; hyperchromasia; coarse chromatin; nuclear membrane irregularity; 3D alterations; and molding. Results: The mean age of the patients was 37 years (range 15-78). Thirty-seven cases were 30 years old or younger. Follow-up was not available for 11 cases. Seventy two cases were HPV+. None of HPV- cases developed HSIL. The following cytological data showed statistical significance: coarse chromatin and HPV positivity (p = 0.007); nuclear membrane irregularity and HSIL in the follow-up (p = 0.015); and molding and HSIL in the follow-up in HPV+ cases (p = 0.046). Conclusions: The HPV test is useful for ASCH cases. Some nuclear alterations in ASCH can predict HPV positivity and HSIL in the follow-up.