Nondiagnostic Squamous Atypia of the Cervix (Atypical Squamous Epithelium of Undetermined Significance): Histologic and Molecular Correlates
| Autor: | C J Prasad, David R. Genest, Christopher P. Crum |
|---|---|
| Rok vydání: | 1994 |
| Předmět: |
Pathology
medicine.medical_specialty Concordance Uterine Cervical Neoplasms Context (language use) Pathology and Forensic Medicine Atypia medicine Humans skin and connective tissue diseases Papillomaviridae Cervix Observer Variation Vaginal Smears business.industry Papillomavirus Infections Obstetrics and Gynecology Histology Uterine Cervical Dysplasia medicine.disease female genital diseases and pregnancy complications Epithelium Squamous metaplasia Tumor Virus Infections medicine.anatomical_structure DNA Viral Female business Precancerous Conditions Kappa |
| Zdroj: | International Journal of Gynecological Pathology. 13:220-227 |
| ISSN: | 0277-1691 |
| Popis: | The histologic criteria for reactive/reparative lesions and precursor lesions (squamous intraepithelial lesions; SIL) of the cervix are established, but a proportion of cervical biopsies contains squamous epithelial alterations that do not fall into either category (nondiagnostic squamous atypia or atypical squamous epithelium of undetermined significance). This study examined (a) the degree to which this diagnosis could be made consistently between two experienced pathologists and (b) its relationship to papillomavirus nucleic acids. One author selected 37 cervical biopsies with a spectrum of cellular changes occurring in the context of inflammatory or reactive epithelial changes, and each case was reviewed by two pathologists independently and classified as reactive, nondiagnostic atypia, and diagnostic (SIL). Concordance between two observers was highest for a diagnosis of SIL (kappa = 0.68), followed by reparative/reactive (kappa = 0.48). Concordance for a designation as nondiagnostic squamous atypia was fair (kappa = 0.39). Seven of 37 (19%) cases were HPV positive, including 2/7, 5/19, and 0/11 cases designated by at least one observer as SIL, nondiagnostic squamous atypia, or neither (i.e., both reactive), respectively. The findings support a category of nondiagnostic squamous atypia but emphasize the value of a second observer and possibly, HPV DNA testing, in resolving such cases. Similarities in HPV positivity between nondiagnostic atypia and SIL in this study may reflect problems of both criteria selection and consistent application of these criteria in a setting of reactive/reparative changes. |
| Databáze: | OpenAIRE |
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