Determination of features indicating progression in atypical squamous cells with undetermined significance: XXXX typing and DNA ploidy analysis from liquid-based cytologic samples.

@entity1 @entity10479 @entity5 @entity2622 @entity281 @entity1082 @entity2784 @entity3146
BACKGROUND: The Bethesda System of cervical cytologic findings introduced the term @entity10479 ( @entity10479 ) to cover the broad zone separating normal cytomorphology from definitive @entity2784 ( @entity2784 ). The management of @entity1 with @entity10479 is particularly problematic as approximately 10% of @entity10479 @entity1 develop SIL and 1 per 1000 develop @entity2622 . METHODS: Our aim was to demonstrate the combined use of polymerase chain reaction for @entity1082 ) typing and laser scanning cytometry for DNA content measurements in the subcategorization of @entity10479 cases according to the risk for progression toward @entity5 . Liquid- based monolayer preparation (ThinPrep, Cytyc, Boston, MA) of the cytologic material was used for cytomorphologic analysis. DNA content measurements using laser scanning cytometry and direct sequencing of HPV using the consensus primers GP5+/GP6+ and MY09/MY11 were performed from the same material. RESULTS: Twelve of the 44 cases (27.2%) with @entity10479 carried a high-risk HPV genome whereas only 3 of the 195 normal control cases (1.5%) showed positivity for a high-risk HPV genome. Six of 12 (50%) of the high-risk HPV-positive @entity10479 cases presented isolated cells with a DNA content above 5c, whereas cells with a DNA content above 9c were found in 3 of 12 cases (25%) and were exclusively found in combination with high-risk HPV @entity281 . In these three cases, the histologic follow-up resulted in @entity3146 (one case) and @entity3146 (two cases). None of the other @entity10479 or normal cases displayed DNA aneuploidy above 9c. They returned to normal cytology (within normal limits/benign cellular changes) in the follow-up. CONCLUSIONS: @entity1082 typing and DNA content measurements may delineate a distinct group of @entity10479 . Our preliminary data suggest that @entity10479 cases with high-risk HPV positivity and with rare cells with abnormally high DNA content represent similar biologic features as high-grade SIL and are at elevated risk to develop @entity5 .
