Dates back to 1991
I. Benign cellular changes
- Infection (trich, fungi, BV, HSV, etc.)
- Reactive changes (associated inflammation, atrophy, IUD, etc.)
II. Epithelial cell information
- Squamous cell evaluation: four possible classifications
- Refers to squamous cell abnormalities not attributable to reactive changes alone, but not characteristic of an SIL (i.e. if a specific cause, like trich, can be identified, won't be reported as ASCUS).
- Should say whether reactive or neoplastic classification is favored; formerly known as "Class II"
- 5% of paps; ass'd w/HPV in up to 75% of cases; more common in women under 40
- LGSIL: includes former categories of "mild dysplasia," "Class III," CIN I, "HPV changes."
- Usually goes back to normal without treatment, some will go on to precancerous lesions. About 20% will be found to have CIN II or CIN III on colpo-directed bx.
- HGSIL: includes former categories of "moderate/severe dysplasia," CIN 2, CIN 3, CIS
- Squamous cell carcinoma (72% of all cervical Ca)
- Glandular cell evaluation
- Endocervical cells (benign)
- Endometrial cells: normal in first half of menstrual cycle, but their presence in second half of menstrual cycle or in a smear from a postmenopausal pt is abnormal (ass'd w/adenocarcinoma in approx. 10% of cases!)
- Atypical glandular cells of undetermined significance: should say whether reactive or neoplastic classification is favored
- Endocervical or endometrial adenocarcinoma
- Other cancers
- Hormonal evaluation (on vaginal cells)