{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T09:10:39Z","timestamp":1761988239085},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2009,10,7]],"date-time":"2009-10-07T00:00:00Z","timestamp":1254873600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2010,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Despite the two\u2010tiered classification of dysplasia in The Bethesda System (TBS), rare cases fall into the category squamous intraepithelial lesion (SIL) of indeterminate grade. These Pap tests are often interpreted as \u201cLSIL\/ASC\u2010H\u201d or \u201cLSIL\u201d with a comment indicating the presence of cells with features approaching HSIL. Patients with LSIL\/ASC\u2010H have a significant risk of CIN 2 or worse (29\u201361.5%) on follow\u2010up cervical biopsies, similar to the risk of CIN 2 or worse in patients with ASC\u2010H Pap tests (24\u201368%). The purpose of this study was to compare patients with ASC\u2010H and LSIL\/ASC\u2010H Pap tests. Women with LSIL\/ASC\u2010H had a slightly lower incidence of CIN 2 or worse (PPV = 35.6%, 95% CI: 29.8\u201341.4%) on follow\u2010up cervical biopsy than the control ASC\u2010H group (PPV = 40.2%, 95% CI: 31.9\u201356.3%); this difference was not statistically significant. The difference in the distribution of the biopsy results between the two groups was statistically significant (<jats:italic>P<\/jats:italic> &lt; 0.001). The current guidelines for the management of cervical cytologic abnormalities from the American Society for Colposcopy and Cervical Pathology (ASCCP) advocate similar treatment algorithms for both LSIL and ASC\u2010H. The main difference is the option of cytologic follow\u2010up or HPV testing for certain \u201cspecial populations,\u201d as an alternative to colposcopy, for LSIL Pap test results. Based on our results, we recommend (1)LSIL\/ASC\u2010H to be added to TBS classification and (2) Pap test cases of LSIL\/ASC\u2010H may need to be clinically followed in a manner similar to ASC\u2010H, i.e., colposcopy for all patients. Diagn. Cytopathol. 2010. \u00a9 2009 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/dc.21194","type":"journal-article","created":{"date-parts":[[2009,10,7]],"date-time":"2009-10-07T19:36:04Z","timestamp":1254944164000},"page":"313-317","source":"Crossref","is-referenced-by-count":14,"title":["Comparison of the clinical significance of the Papanicolaou test interpretations LSIL cannot rule out HSIL and ASC\u2010H"],"prefix":"10.1002","volume":"38","author":[{"given":"Megan J.","family":"Difurio","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Mailhiot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Sundborg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen K.","family":"Nauschuetz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2010,4,14]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4612-2042-8"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1309\/JM3V-U4HP-W8HJ-68XV"},{"key":"e_1_2_1_4_2","first-page":"335","article-title":"Cytologic features, histologic correlates, and human papillomavirus detection","volume":"12","author":"Sherman ME","year":"1999","journal-title":"Mod Pathol"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/dc.10286"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1309\/NPU3WRQCTAB81XLW"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/dc.10303"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1159\/000325475"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(16)32280-0"},{"issue":"2","key":"e_1_2_1_10_2","first-page":"71A","article-title":"Utilization of ASC\u2010H, LSIL, cannot exclude HSIL (LSIL\u2010H) and HSIL terminology following implementation of the ThinPrep imaging system","volume":"20","author":"Howard MT","year":"2007","journal-title":"Mod Pathol"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22169"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1309\/QRDNMWWAKJQTVJGF"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/1742-6413-4-7"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.20004"},{"issue":"5","key":"e_1_2_1_15_2","first-page":"378","article-title":"Clinical outcomes of patients with a cytologic interpretation of \u201cLSIL, cannot exclude HSIL (LSIL\u2010H)\u201d in Pap tests: A Retrospective Follow\u2010up Study","volume":"108","author":"Underwood D","year":"2006","journal-title":"Cancer Cytopathol"},{"issue":"5","key":"e_1_2_1_16_2","first-page":"370","article-title":"Low\u2010grade squamous intraepithelial lesion cannot exclude high\u2010grade squamous intraepithelial lesion (LGSIL\u2010H): Do we need another category in Bethesda System?","volume":"108","author":"Wang Y","year":"2006","journal-title":"Cancer Cytopathol"},{"issue":"5","key":"e_1_2_1_17_2","first-page":"387","article-title":"Evaluation of low\u2010grade squamous intraepithelial lesion, cannot exclude high\u2010grade squamous intraepithelial lesion on cervical smear","volume":"108","author":"Hong SR","year":"2007","journal-title":"Cancer Cytopathol"},{"key":"e_1_2_1_18_2","first-page":"523","article-title":"Cervical biopsy\u2010cytology correlation. A College of American Pathologists Q\u2010Probes Study of 22,439 correlations in 348 laboratories","volume":"120","author":"Jones BA","year":"1996","journal-title":"Arch Pathol Lab Med"},{"key":"e_1_2_1_19_2","first-page":"462","article-title":"Reporting of \u201cLSIL with ASC\u2010H\u201d on cervicovaginal smears: Is it a valid category to predict cases with HSIL follow\u2010up?","volume":"25","author":"Kir G","year":"2004","journal-title":"Eur J Gynecol Oncol"},{"key":"e_1_2_1_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.11721"},{"key":"e_1_2_1_21_2","first-page":"857","article-title":"Clinical significance of the Pap smear diagnosis of LSIL cannot exclude HSIL: Comparison with a patient population with Pap smear findings of LSIL [abstract]","volume":"44","author":"Walsh BG","year":"2000","journal-title":"Acta Cytol"},{"key":"e_1_2_1_22_2","first-page":"668","article-title":"Cervicovaginal cytology specimens: Biopsy follow\u2010up and clinical significance [abstract]","volume":"48","author":"Baker JJ","year":"2004","journal-title":"Acta Cytol"},{"key":"e_1_2_1_23_2","first-page":"659","article-title":"Clinical significance of cytologic diagnosis of low\u2010grade squamous intraepithelial lesion with few cells suggestive of high grade: A cytohistologic correlation study [abstract]","volume":"48","author":"Saad RS","year":"2004","journal-title":"Acta Cytol"},{"issue":"1","key":"e_1_2_1_24_2","first-page":"61A","article-title":"Is LSIL, cannot exclude HSIL (LGHSIL) a valid Pap test interpretation?","volume":"18","author":"Booth CN","year":"2005","journal-title":"Mod Pathol"},{"key":"e_1_2_1_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0339(200010)23:4<245::AID-DC6>3.0.CO;2-7"},{"issue":"5","key":"e_1_2_1_26_2","first-page":"383","article-title":"Impact of the ThinPrep imaging system on the frequency of LSIL, cannot exclude HSIL: Correlation of HPV and follow\u2010up data","volume":"108","author":"O'Brien D","year":"2006","journal-title":"Cancer Cytopathol"},{"key":"e_1_2_1_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.07.047"},{"key":"e_1_2_1_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.03.060"},{"key":"e_1_2_1_29_2","doi-asserted-by":"publisher","DOI":"10.5858\/132.12.1874"}],"container-title":["Diagnostic Cytopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fdc.21194","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.21194","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T23:20:16Z","timestamp":1700608816000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/dc.21194"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,4,14]]},"references-count":28,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2010,5]]}},"alternative-id":["10.1002\/dc.21194"],"URL":"https:\/\/doi.org\/10.1002\/dc.21194","archive":["Portico"],"relation":{},"ISSN":["8755-1039","1097-0339"],"issn-type":[{"value":"8755-1039","type":"print"},{"value":"1097-0339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,4,14]]}}}