ASCUS.pdf

의료인을 위한 유튜브 링크 : https://youtu.be/cTYyN4WJca0

자궁경부암은 HPV 바이러스에 의해 생기는 것으로 알려진 여성의 생식기 암이다

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

자궁경부암 검사중 ASCUS는 atypical squamous cells of uncertain significance의 약자로 말 그대로 암이 의심되지만 암이라고 말할 수 없는, 자궁경부 세포의 비정형적 변화이다.

ASCUS는 가장 흔한 비정상 결과로, 암이 될 확률은 다른 비정상 결과들과 비교해 가장 낮다.

ASCUS가 결과로 나올 경우 할 검사는
1. 1년뒤 재검
2. 인유두바이러스검사

왜냐하면 인유두 바이러스에 걸렸을 경우 자궁경부암 위험이 더 크기 때문이다.

 In clinical setting, we frequently hear ASCUS as pap smear result. But what exactly is ASCUS?

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ASCUS stands for atypical squanous cells of undetermined significance. It is the most common abnormal result of pap smear, a screening test for cervical cancer.
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the meaning of ascus, then, is some cellular changes that are suspicious but are not conlusive of neoplasm
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So ASCUS is a diagnosis made by cytology, meaning that there are some atypical cells which may have risk of cancer. But ASCUS runs least risk of developing to cancer, especially more so if the patient is not infected with HPV
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HPV, human papilloma virus is an identified cause of cervical cancer. There are many virus types, and some have high risks of developing cancers while others do not.
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The initial management can be summed as follows. Very simple.
So in case the test result is ASCUS, HPV testing is recommended to stratify the risk of cervical neoplasm in the future. Some patients, who first present with ASCUS, actually turns out to have cervical neoplasm , especially in case they are HPV carrier. For this reason, HPV testingis recommended.
Or another approach to ASCUS may be to do a follow up co-test in one year.
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In both cases, if the tests turn out to be negative, they will simply need followup every three year.

But in cases the next step they took shows bad results, colposcopy will be done. Through colposcopy, doctors will look for lesions, in medical term squamous intraepithelial lesions, and if needed, will conduct biopsies.

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There are always exceptions.
what is patients have persistent HPV positive result while nothing on colposcopy?
then in this case, annual colposcopy is recommended
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another question! what if the patient does not carry HPV while persistently have ASCUS?
here again, co-testing is recommended every three years.
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