The Lower Anogenital Squamous Terminology Standardization Project for HPV-Associated Lesions: background and consensus recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology
Teresa M Darragh, Terence J Colgan, J Thomas Cox, Debra S Heller, Michael R Henry, Ronald D Luff, Timothy McCalmont, Ritu Nayar, Joel M Palefsky, Mark H Stoler, Edward J Wilkinson, Richard J Zaino, David C Wilbur, Members of LAST Project Work Groups, David C Wilbur, Teresa M Darragh, Michael R Henry, Timothy McCalmont, Ronald D Luff, Edward J Wilkinson, J Thomas Cox, Dennis M O'Connor, R Kevin Reynolds, M Angelica Selim, James Scurry, Michael R Henry, David Chelmow, Lydia P Howell, Brigitte Ronnett, Alan G Waxman, Timothy McCalmont, Hope K Haefner, Kieron S Leslie, Christopher Shea, Paul N Staats, Joel M Palefsky, Leona Council, Alice Lytwyn, Barbara Winkler, Jennifer Roberts, Terence J Colgan, Levi Downs, Rodolfo Laucirica, Richard J Zaino, Debra S Heller, Jill Allbritton, Olga Ioffe, Nancy Joste, Teresa M Darragh, J Michael Berry, Oscar Lin, Mark Welton, Christopher N Otis, David C Wilbur, Mark H Stoler, Joel S Bentz, Christina S Kong, Bradley Quade, Mary R Schwartz, Sarah M Bean, Ronald D Luff, Ritu Nayar, Philip E Castle, Marie Duggan, Francisco A R Garcia, Ann T Moriarty, G Chip Niedt, Alicia Carter, Marc Goodman, Margaret Neal, Vijaya Reddy, Stanley Robboy, Mona Saraiya, Steven Silverberg, Susan Spires, Teresa M Darragh, Terence J Colgan, J Thomas Cox, Debra S Heller, Michael R Henry, Ronald D Luff, Timothy McCalmont, Ritu Nayar, Joel M Palefsky, Mark H Stoler, Edward J Wilkinson, Richard J Zaino, David C Wilbur, Members of LAST Project Work Groups, David C Wilbur, Teresa M Darragh, Michael R Henry, Timothy McCalmont, Ronald D Luff, Edward J Wilkinson, J Thomas Cox, Dennis M O'Connor, R Kevin Reynolds, M Angelica Selim, James Scurry, Michael R Henry, David Chelmow, Lydia P Howell, Brigitte Ronnett, Alan G Waxman, Timothy McCalmont, Hope K Haefner, Kieron S Leslie, Christopher Shea, Paul N Staats, Joel M Palefsky, Leona Council, Alice Lytwyn, Barbara Winkler, Jennifer Roberts, Terence J Colgan, Levi Downs, Rodolfo Laucirica, Richard J Zaino, Debra S Heller, Jill Allbritton, Olga Ioffe, Nancy Joste, Teresa M Darragh, J Michael Berry, Oscar Lin, Mark Welton, Christopher N Otis, David C Wilbur, Mark H Stoler, Joel S Bentz, Christina S Kong, Bradley Quade, Mary R Schwartz, Sarah M Bean, Ronald D Luff, Ritu Nayar, Philip E Castle, Marie Duggan, Francisco A R Garcia, Ann T Moriarty, G Chip Niedt, Alicia Carter, Marc Goodman, Margaret Neal, Vijaya Reddy, Stanley Robboy, Mona Saraiya, Steven Silverberg, Susan Spires
Abstract
The terminology for human papillomavirus(HPV)–associated squamous lesions of the lower anogenital tract has a long history marked by disparate diagnostic terms derived from multiple specialties. It often does not reflect current knowledge of HPV biology and pathogenesis. A consensus process was convened to recommend terminology unified across lower anogenital sites. The goal was to create a histopathologic nomenclature system that reflects current knowledge of HPV biology, optimally uses available biomarkers, and facilitates clear communication across different medical specialties. The Lower Anogenital Squamous Terminology (LAST) Project was co-sponsored by the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology and included 5 working groups; 3 work groups performed comprehensive literature reviews and developed draft recommendations. Another work group provided the historical background and the fifth will continue to foster implementation of the LAST recommendations. After an open comment period, the draft recommendations were presented at a consensus conference attended by LAST work group members, advisors, and representatives from 35 stakeholder organizations including professional societies and government agencies. Recommendations were finalized and voted on at the consensus meeting. The final, approved recommendations standardize biologically relevant histopathologic terminology for HPV-associated squamous intraepithelial lesions and superficially invasive squamous carcinomas across all lower anogenital tract sites and detail the appropriate use of specific biomarkers to clarify histologic interpretations and enhance diagnostic accuracy. A plan for disseminating and monitoring recommendation implementation in the practicing community was also developed. The implemented recommendations will facilitate communication between pathologists and their clinical colleagues and improve accuracy of histologic diagnosis with the ultimate goal of providing optimal patient care.
Source: PubMed