Cytological diagnosis of atypical squamous cells: a critical evaluation of diagnostic guidelines

Revista brasileira de ginecologia e obstetrícia : revista da Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
Fábio RussomanoRoberta Osta Mousinho

Abstract

to identify valid guidelines for the approach of women with cytopathological diagnosis of undetermined significance atypias in squamous cells (ASC), discussing its applicability to the Brazilian scenario. an electronic search of publications at PubMed, National Guidelines Clearinghouse and Scholar Google was carried out, as well as a manual search of references from the texts found. The guidelines identified, and specifically related to the theme, were evaluated according to its validity and the recommendations were criticized and summarized. guidelines for the United Kingdom, France, Australia, the USA and New Zealand have been considered as valid. These documents recommend repeating the cytology in six or twelve months, in ASCs of undetermined significance (ASC-US) before referring to colposcopy, and immediate referral to colposcopy in ASCs, when it is not possible to disregard high degree lesions (ASC-H). We have also found valid colposcopy recommendations for women with ASC-US in special situations (immune deficient women requiring specialist assistance) and the use of oncogenic HPV test, which, when present in women over 20, should motivate referral to colposcopy. the clinical guidelines recommended for the Programa Nacion...Continue Reading

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