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Reproducibility of Diagnosis of ASC-US, Reflection of Diagnostic Criteria to Cervical Histopathological Results and Investigation of p16 Antibodies in Cervical Biopsies
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Original Article
VOLUME: 50 ISSUE: 1
P: 50-55
2017

Reproducibility of Diagnosis of ASC-US, Reflection of Diagnostic Criteria to Cervical Histopathological Results and Investigation of p16 Antibodies in Cervical Biopsies

Acta Haematol Oncol Turc 2017;50(1):50-55
DOI: 10.5505/aot.2017.47450
Zehra Edebal
Egemen Akıncıoğlu
Mine Kiseli
Handan Doğan
Aslı Yarcı Gürsoy
Ömür Ataoğlu
1. Department of Pathology, Beyhekim State Hospital, Konya, Turkey
2. Department of Pathology, Ufuk University, Ankara, Turkey
3. Department of Gynecology and Obstetrics, Ufuk University, Balgat, Ankara, Turkey
4. Mikro-Pat Pathology Laboratory, Kizilay, Ankara, Turkey
5.
No information available.
No information available
Received Date: 2016-06-05T23:24:10
Accepted Date: 2017-04-05T17:10:20
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Abstract

INTRODUCTION

We aimed to investigate reproducibility of diagnosis, presence of Bethesda criteria and their reflection to histopathology in Papanicolau (PAP) smears with atypical squamous cells of undetermined significance (ASC-US). We also searched for p16 antibody positivity in cervical biopsy specimens of the patients with diagnosis of ASC-US.

METHODS

33 patients who had undergone cervicopathologic evaluation were chosen from patients given ASC-US diagnosis in our department between 2006 and 2013 for this study. All the Pap smear specimens were re-evaluated simultaneously by two pathologists. The specimens were evaluated for positivity of each Bethesda ASC-US diagnostic criteria separately. The biopsy specimens were stained with p16 antibody.

RESULTS

The reproducibility rate of cytology reports for Pap smear specimens diagnosed as ASC-US was found 88%. Neither of the Bethesda diagnostic criteria showed significant precedence over each other for frequency of presence in cervical intraepithelial neoplasia (CIN) 1 and non-malignant cases (P>0.05). Mean number of positive diagnostic criteria was 2.7±0.9 when ASC-US cases were considered altogether. There was no statistically significant difference between CIN cases and non-malignant cases for average number of positive diagnostic criteria. Histopathology specimens of these cases had an 18% of staining rate for p16 antibody. It was found that immunohistochemical staining had a 46% of sensitivity and 100% specificity for diagnosing CIN.

DISCUSSION AND CONCLUSION

An underlying cervical intraepithelial neoplasia was determined in 39% of cases diagnosed as ASC-US using Bethesda diagnostic criteria. Neither of the Bethesda diagnostic criteria exhibited superiority alone in foreseeing probable neoplastic changes. Presence of each Bethesda diagnostic criteria should be analyzed independently and existence of at least two, favorably three criteria should be preferred for diagnosing ASC-US. p16 antibody showed low false positive rate, thus distinguishing the cases with a potential of neoplastic formation became rather easy. p16 staining will become an important diagnostic instrument when used concomitant with cytopathology.