Atypical glandular cells of undetermined significance: implications for management in a dysplasia clinic.

Abstract

The natural evolution of atypical glandular cells of undetermined significance (AGUS) within a dysplasia clinic population has not yet been studied. The purpose of this study was to determine the outcome of cervico-vaginal smears with the diagnosis of AGUS from dysplasia clinic patients. The cytopathological files of the Ottawa Civic Hospital were reviewed retrospectively from January 1993 to December 1995. In 59 dysplasia clinic patients, AGUS was diagnosed on one or more cervico-vaginal smears. Histological follow-up was available from 34 patients. Cytological follow-up was available on an additional 17 patients. Nineteen patients had clinically significant lesions. In eight patients, squamous intraepithelial neoplasia was diagnosed; in five, adenocarcinoma in situ; in another five, adenocarcinoma; and, in one patient, endometrial hyperplasia with atypia. In 15 patients, follow-up was negative. In a dysplasia clinic population in whom there was a cytological diagnosis of AGUS, we found 32% had significant pathology. Of these patients, 53% had glandular pathology. Based on our experience, histological assessment of the endocervix is suggested in these patients.