Borderline nuclear change; can a subgroup be identified which is suspicious of high-grade cervical XXXX , i e CIN 2 or worse?

@entity5 @entity1893 @entity2286 @entity5436
Borderline nuclear change; can a subgroup be identified which is suspicious of high-grade cervical @entity5436 , i.e. CIN 2 or worse? Only 10% of first borderline smears are associated with a histological high-grade (HG) abnormality, i.e. CIN 2,3, invasive @entity5 on subsequent investigation. The advantages of highlighting this subgroup are obvious but is this possible? From 1996 and 1997, 242 borderline smears with histological follow-up were examined by two independent experienced observers (observer 1 and 2) without prior knowledge of further investigation results. For each smear a profile of nuclear details was produced, also noting the type of cell mainly affected by the process; then the observers were asked to assess the degree of @entity1893 for each smear i.e. whether the smear fell into group 1 borderline changes indicative of low-grade (normal, inflammatory, CIN1/HPV) disease (BL/LG) or group 2 difficult borderline smear, HG disease (CIN 2,3, invasive @entity5 ) cannot be excluded (BL/HG). Observer 1 selected a group of BL/HG with a @entity2286 for HG disease of 38%, with observer 2 having a @entity2286 of 50%; this compared with the overall laboratory HG disease @entity2286 for borderline smears of 14%. Both observers found the most useful criterion to be the increase in nuclear:cytoplasmic ratio. Our results show that it is possible to separate a small group of borderline smears which should be classified as 'borderline/high grade lesion difficult to exclude' (BL/HG). Both observers had some success in arriving at this classification although their method of selecting out this group was quite different.
