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- 女，44岁，宫颈TCT--上传活检
| 以下是引用mingfuyu在2008-9-1 22:36:00的发言：
ASCUS. Cells have atypia but also significant prep artifact. Artifact (air-dryigng, degeneration) can enlarge nuclei and loose cytoplasma, thus increase N/C ratio and mimick HSIL. Smear artifact can also cause significant glandular atypia. We are cautious about calling ASC-H and AGC because the standard care for ASC-H is colposcopy and biopsy in many institutions without triggering HPV test, while ASCUS triggers HPV test and can sort out the issue before the stress goes to patients. If HPV is positive, we then suggest colposcopy. If HPV is negative, patients can be followed by pap smears. I don't know the practice in China as when patients get HPV tests and how a ASC or ASC-H are treated. Just to share our practice here. High risk HPV test has very strong predictive value for HSIL and above. If you worry enought for HSIL and warrant a colposcopy, sure, you can call it ASC-H. |
- 广州金域病理
ASCUS. Cells have atypia but also significant prep artifact. Artifact (air-dryigng, degeneration) can enlarge nuclei and loose cytoplasma, thus increase N/C ratio and mimick HSIL. Smear artifact can also cause significant glandular atypia. We are cautious about calling ASC-H and AGC because the standard care for ASC-H is colposcopy and biopsy in many institutions without triggering HPV test, while ASCUS triggers HPV test and can sort out the issue before the stress goes to patients. If HPV is positive, we then suggest colposcopy. If HPV is negative, patients can be followed by pap smears.
I don't know the practice in China as when patients get HPV tests and how a ASC or ASC-H are treated. Just to share our practice here. High risk HPV test has very strong predictive value for HSIL and above.
If you worry enought for HSIL and warrant a colposcopy, sure, you can call it ASC-H.
