Clinical significance of atypical glandular cells on cytology: 10 years' experience of a colposcopic referral center.
Journal
European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP)
ISSN: 1473-5709
Titre abrégé: Eur J Cancer Prev
Pays: England
ID NLM: 9300837
Informations de publication
Date de publication:
23 Jul 2024
23 Jul 2024
Historique:
medline:
16
8
2024
pubmed:
16
8
2024
entrez:
16
8
2024
Statut:
aheadofprint
Résumé
'Atypical glandular cells' (AGC) is an uncommon cytological result of cervical Pap smears which includes a wide of histopathological diagnoses, from benign to premalignant and malignant cervical disorders, endometrial cancer and, occasionally, other genital malignancies. This study aims to provide a comprehensive overview of AGC, assessing risk factors and clinical and histological features in affected patients. A retrospective analysis was conducted on a cohort of 239 women diagnosed with AGC between 2012 and 2022 at the 'Regional Referral Center for Prevention, Diagnosis and Treatment of HPV-related Genital Disorders', Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. Following AGC detection, patients underwent colposcopy with endocervical sampling and endometrial assessment via pelvic ultrasound. Selective cases also received endometrial biopsies. Among a total of 190 women who underwent both colposcopy and endometrial assessment, 116 (61%) had negative clinical and histopathological findings. The remainder displayed various abnormalities: 36 women (18.9%) were found to have endometrial or cervical polyps, 23 (12.1%) were diagnosed with preinvasive cervical neoplasia, and 21 (10.9%) with invasive cervical or endometrial disease. Menopause, multiparity, and older age were all significantly associated with endometrial cancer, but none of the abovementioned variables were significantly associated with cervical neoplasia. Our data confirm that AGC may reveal the presence of a wide range of histopathological conditions. Patients diagnosed with AGC should undergo a careful evaluation including both colposcopy with endocervical sampling and an endometrial assessment.
Identifiants
pubmed: 39150089
doi: 10.1097/CEJ.0000000000000910
pii: 00008469-990000000-00160
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Références
Arshi J, Farci F (2022). Atypical glandular cells (AGS). In: StatPearls. StatPearls Publishing; October 17, 2022.
Boyraz G, Basaran D, Salman MC, Ibrahimov A, Onder S, Akman O, et al. (2017). Histological follow-up in patients with atypical glandular cells on pap smears. J Cytol 34:203–207.
Ciavattini A, Giannella L, Delli Carpini G, Tsiroglou D, Sopracordevole F, Chiossi G, et al. (2019). Adenocarcinoma in situ of the uterine cervix: clinical practice guidelines from the Italian society of colposcopy and cervical pathology (SICPCV). Eur J Obstet Gynecol Reprod Biol 240:273–277.
Graue R, Lönnberg S, Skare GB, Saether SMM, Bjørge T (2020). Atypical glandular lesions of the cervix and risk of cervical cancer. Acta Obstet Gynecol Scand 99:582–590.
Jang TK, Park JY, Kim DY, Suh DS, Kim JH, Kim YM, et al. (2019). Histologic correlation and clinical significance of atypical glandular cells on cervical pap tests: analysis of 540 cases at a single institution. Cancer Invest 37:8–15.
Jeng CJ, Liang HS, Wang TY, Shen J, Yang YC, Tzeng CR (2003). Cytologic and histologic review of atypical glandular cells (AGC) detected during cervical cytology screening. Int J Gynecol Cancer 13:518–521.
Kalir T, Simsir A, Demopoulos HB, Demopoulos RI (2005). Obstacles to the early detection of endocervical adenocarcinoma. Int J Gynecol Pathol 24:399–403.
Keles E, Ozturk UK, Alinca CM, Giray B, Kabaca C, Cetiner H (2021). Factors affecting the histopathological outcomes of atypical glandular cells on pap test. J Cytol 38:210–215.
Khan MYA, Bandyopadhyay S, Alrajjal A, Choudhury MSR, Ali-Fehmi R, Shidham VB (2022). Atypical glandular cells (AGC): cytology of glandular lesions of the uterine cervix. Cytojournal 19:31.
Lepe M, Eklund CM, Quddus MR, Paquette C (2018). Atypical glandular cells: interobserver variability according to clinical management. Acta Cytol 62:397–404.
Lu KH, Broaddus RR (2020). Endometrial cancer. N Engl J Med 383:2053–2064.
Marques JP, Costa LB, Pinto AP, Lima AF, Duarte ME, Barbosa AP, et al. (2011). Atypical glandular cells and cervical cancer: systematic review. Rev Assoc Med Bras (1992) 57:234–238.
Munro A, Williams V, Semmens J, Leung Y, Stewart CJ, Codde J, et al. (2015). Risk of high-grade cervical dysplasia and gynaecological malignancies following the cytologic diagnosis of atypical endocervical cells of undetermined significance: a retrospective study of a state-wide screening population in Western Australia. Aust N Z J Obstet Gynaecol 55:268–273.
Munro A, Codde J, Spilsbury K, Steel N, Stewart CJ, Salfinger SG, et al. (2017). Risk of persistent and recurrent cervical neoplasia following incidentally detected adenocarcinoma in situ. Am J Obstet Gynecol 216:272.e1–272.e7.
Nayar R, Wilbur DC (2015). The Pap test and Bethesda 2014. Cancer Cytopathol 123:271–281.
Perkins RB, Guido RS, Castle PE, Chelmow D, Einstein MH, Garcia F, et al. (2020). 2019 ASCCP risk-based management consensus guidelines for abnormal cervical cancer screening tests and cancer precursors. J Low Genit Tract Dis 24:102–131.
Pradhan D, Li Z, Ocque R, Patadji S, Zhao C (2016). Clinical significance of atypical glandular cells in Pap tests: an analysis of more than 3000 cases at a large academic women’s center. Cancer Cytopathol 124:589–595.
Schnatz PF, Guile M, O’Sullivan DM, Sorosky JI (2006). Clinical significance of atypical glandular cells on cervical cytology. Obstet Gynecol 107:701–708.
Toyoda S, Kawaguchi R, Kobayashi H (2019). Clinicopathological characteristics of atypical glandular cells determined by cervical cytology in Japan: survey of gynecologic oncology data from the obstetrical gynecological society of Kinki District, Japan. Acta Cytol 63:361–370.
Ullal A, Roberts M, Bulmer JN, Mathers ME, Wadehra V (2009). The role of cervical cytology and colposcopy in detecting cervical glandular neoplasia. Cytopathology 20:359–366.
Wang J, Andrae B, Sundström K, Ström P, Ploner A, Elfström KM, et al. (2016). Risk of invasive cervical cancer after atypical glandular cells in cervical screening: nationwide cohort study. BMJ 352:i276.
Zhao C, Florea A, Onisko A, Austin RM (2009). Histologic follow-up results in 662 patients with Pap test findings of atypical glandular cells: results from a large academic women’s hospital laboratory employing sensitive screening methods. Gynecol Oncol 114:383–389.