Poster Session

P10. Clinical significance of atypical squamous cells of undetermined significance in detecting preinvasive cervical lesions in pre and post menopausal Albanian women

Eliona Demaliaj (AL), Bashkim Ismaili (MK), Eden Hoxha (AL)

[Demaliaj] "Mbretëresha Geraldinë" Hospital , Tirana. Obstetrics-Gynecology Department, Faculty of Medicine, Medical University, Tirana. , [Ismaili] Special hospital of Obstetrics and Gynecology "Nëna Terezë" Skopje, [Hoxha] Matrix Medical Centre

Background: To evaluate the clinical significance of atypical squamous cells of undetermined significance (ASCUS) in PAP test in post-menopausal women and compare with pre -enopausal women. Methods: A total of 500 patients who referred to our gynecologic clinic in “ Mbreteresha Geraldine” Hospital, Tirane, Albania, were included to the study between January 2012 and August 2014. Data for 194 post-menopausal (group 1) and 306 pre-menopausal (group 2) women with ASCUS cytology were evaluated. Patients interventions: Immediate colposcopy and endocervical curettage was performed for both groups and conization for all women with a result suggestive of CIN2-3. HPV –DNA were assessed for all woman. Main outcome measures: Histopathological results and demographic features of patients were compared between the two groups. Results: Mean age of the patients was 54.6±6.5 years in group 1 and 38±6.6 years in group 2. Some 19 (9.4%) of post- menopausal women and 49 (15.9%) of pre-menopausal women were current smokers. No one was suffering from another disease. Totals of post-menopausal and pre-menopausal women were assessed for HPV-DNA. HPV –DNA testing was performed by polymerase chain reaction (PCR) with pU1M/pU2R primers in GENOMA Laboratory, Rome, Italy. High risk HPV was detected in 27 (14 %) and 85 (28 %), respectively (p=0.029). Final histopathological results recorded were normal cervix, low grade cervical intra-epithelial neoplasia (CIN 1), and high grade cervical intra-epithelial neoplasia (CIN2-3). In group 1, results were 84.8%, 12.2% and 1.8%, respectively, and in group 2 were 71.9%, 23.2% and 4.9%. Two cases were detected as micro-invasive carcinoma in pre-menopausal group (1%). Two cases were detected as endometrial carcinoma in the menopausal group (0.6 %). Conclusions: In current study we found that preinvasive lesions were statistically significantly higher in pre-menopausal women than post-menopausal women with ASCUS. High risk HPV were significantly higher in pre-menopausal women. Cervicitis was more common in menopausal women.