04. ASC-H - 자궁경부암 검사 (pap smear) 해석

ASC-H.pdfASC-H.pdf

 

의료인을 위한 유튜브 링크 : https://youtu.be/88VQA1B_8ak

 

 

 

자궁경부암은 인유두종 바이러스에 의해 생기는 것으로 알러진 여성의 생식기 암이다

자궁 경부암은 증상이 없기 때문에 pap smear, 즉 자궁 경부암 검사를 통해 최근에 조기에 발견되고 있다.

ASC-H는 비정형 세포로, 고등급 형성이상 암을 배제할 수 없는 결과이다. 

다른 결과와 달리, 인유두종 바이러스와 관련이 있을 가능성이 매우 높으며 조직검사에서 전암병변이 많이 발견된다.

이 결과가 나온 모든 환자는 질확대경검사 대상이 되며, 상피내 병변이 발견되는 경우 절제 등의 치료를 필요로한다. 

ASCH is the result of pap smear that sounds rather quizzy. 

1. Definition

Asch stands for atypical squamous cells, cannot exclude high-grade

intraepithelial lesion

 

 

As is obvious from its name, asch carries higher risk of cervical  neoplasm, but lower than Hsil

2. Significance

As is well known, HPV is the identified cause of cervical neoplasm. 

In other test results, running the HPV test was a recommended step in other results introduced in my other videos.

However, in case of ASCH, HPV testing is deemed inappropriate because HPV detection rate is very high in ASCH.

Even though the HPV test turns out to be negative, 5-year cancer risk amounts to 2%. 

3. Management

Then how should ASCH be managed? 

Regardless of age and risk stratification, colopscopy is recommended. 

Again, HPV testing is not recommended.

Mostly, the histology result will be CIN2-3, which needs treatment.

The patient may be treated with either an excisional procedure such as cone biopsy or LEEP or by an ablative procedure such as cryotherapy or CO  ₂  laser

4. Comments

Cervical neoplasm is mostly asymptomatic. However, with adequate screening and diagnosis, its survival is increasing. 

For further study on this subject, my previous videos are recommended.

Thank you for listening and I'll come back again to finally talk about HSIL. See you