REACTIVE CELLULAR-CHANGE - IS THERE AN INCREASED RISK FOR SQUAMOUS INTRAEPITHELIAL LESIONS

BACKGROUND, The aim of this study was to evaluate the rate of squamous intraepithelial lesions (SIL) in women with reactive cellular change (RCC] cervical smears and compare the results with a control group wit h within normal limit (WNL) smears. METHODS. The study group was compr ised of 1000 women with RCC and a control group of 1000 women with WNL cervical smears diagnosed over an 8-month period. Results of the firs t follow-up (FU) smears were evaluated and compared between the two gr oups. FU smears with a diagnosis of SIL were reviewed along with the o riginal RCC or WNL smears. RESULTS. Six hundred and thirteen women fro m the RCC group and 640 from the WNL group had FU smears. The mean tim e to FU was 11.0 and 13.8 months, respectively. FU revealed SIL in 24 of 613 smears in the RCC group (20 low grade [LI SIL and 4 high grade [H] SIL), (3.9%) and in 10 of 640 smears in the WNL group (10 LSIL and 0 HSIL) (1.6%). Fisher's exact test (two-tailed) showed statistical s ignificance (p = 0.014). On retrospective review of the FU smears diag nosed as SIL and their corresponding original RCC or WNL smears, four RCC smears were upgraded to atypical squamous cells of undetermined si gnificance [ASCUS), The remaining diagnoses remained unchanged. CONCLU SIONS. Women with RCC are more Likely to have SIL on a FU smear compar ed with women with WNL smears (3.9% vs. 1.6%). It is important to emph asize that in the authors' laboratory, the rate of SIL in women with A SCUS is much higher (24%). Awareness of these rates combined with the clinical history may help clinicians determine whether women with RCC require closer FU. (C) I997 American Cancer Society.