New cell findings on low-grade squamous intraepithelial lesions (LSIL)-minimizing the atypical squamous cells of undetermined significance (ASC-US) diagnosis rates-

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  • ＬＳＩＬの新たな細胞所見の検討―ＡＳＣ‐ＵＳ判定率の減少を目指して―
  • —minimizing the atypical squamous cells of undetermined significance (ASC-US) diagnosis rates—
  • —ASC-US 判定率の減少を目指して—

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Objective : We studied cytological low-grade squamous intraepithelial lesions (LSIL) guidelines based on the detection of cells with a high-risk of human papillomavirus (HPV) infection in cases of atypical squamous cells of undetermined significance (ASC-US).<br>Study Design : Study materials were liquid cervical cytological specimens from 151 cases diagnosed as ASC-US. We identified HPV infection using L1 polymerase chain reaction (L1-PCR) and identified HPV-infected cells using in situ PCR.<br>Results : High-risk HPV was detected in 86.8% of ASC-US cases. Among 7 cell features indicative of HPV infection, binucleation (compression+) and nuclear enlargement (irregular chromatin distribution) had sensitivity exceeding 40% and specificity exceeding 90% in detecting high-risk HPV. High-risk HPV was detected by in situ PCR in 100% of cells showing binucleation (compression+) and in 81.9% of cells with nuclear enlargement (irregular chromatin distribution). The presence of cells with binucleation (compression+) and nuclear enlargement (irregular chromatin distribution) correlated significantly with high-risk HPV infection (p<0.001).<br>Conclusions : LSIL can be diagnosed without HPV DNA testing when binucleated cells (compression+) are detected in cervical cytology specimens with ASC-US.

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