Pathology correlates of a Papanicolaou diagnosis of low-grade squamous intraepithelial lesion, cannot exclude high-grade squamous intraepithelial lesion.

Abstract

The objective of this study was to compare findings after a cytologic report of low-grade squamous intraepithelial lesion, cannot exclude high-grade squamous intraepithelial lesion (LSIL-H) with findings after a report of low-grade squamous intraepithelial lesion (LSIL). A review of patient records revealed that 312 women had cytologic findings of LSIL-H, and 324 consecutive women in a comparison group had cytologic findings of LSIL during 2005. Findings over 6 months after diagnosis were retrieved and analyzed using chi-square tests, Fisher exact tests, and independent group t tests. Histology was available for 194 of 312 women (64%) with LSIL-H and for 184 of 324 women (57%) with LSIL. Of these, 47 of 194 women (24%) with LSIL-H had grade 2 cervical intraepithelial neoplasia or greater (CIN2+) versus 13 of 184 women (7%) with LSIL (P < .0001). No cancers were identified. High-grade SIL cytology was reported in 2 of 105 women who had LSIL (2%) and in 4 of 93 women who had LSIL-H (4%). Women with LSIL-H who were positive for CIN2+ were younger than those without CIN2+ (25 years vs 30 years; P = .0067) Clinicians whose laboratories report LSIL-H should manage women who have LSIL-H with colposcopy, whereas only serial cytologic surveillance is required after a report of LSIL.