Clinical Evaluation of Follow-Up Methods and Results of Atypical Glandular Cells of Undetermined Significance (AGUS) on Cervicovaginal Pap Smears

Abstract

c s c t u C I a r s c u o c b [ w q t h 5 o c a c Objectives. The aim of this study was to evaluate the efficacy of he follow-up methods and results of atypical glandular cells of ndetermined significance (AGUS) detected on cervicovaginal ap smears. Methods. From May 1991 to December 1996, we have perormed 407, 451 cervicovaginal Pap smears, of which 326 patients ere identified as AGUS. Of the 326 patients, 268 patients were ollowed by repeat Pap smears, colposcopy, cone biopsy, or endoetrial curettage. Results. The incidence of AGUS on Pap smears is approxiately 0.08%. The mean age of the patients was 43 years (range 2–79 years). The most common complaint was abnormal vaginal leeding. The gross findings of the cervix were normal to mild rosion. The following past histories of patients could affect the GUS results on Pap smear: 30 had cone biopsy, 21 had Pap mears on pregnancy and within 8 weeks after delivery or evacution, 3 were on hormonal replacement therapy, 2 had intrauterine evices for contraception, and 5 were undergoing follow-up after reatment of cervical cancer. The benign lesions detected during ollow-up periods were 6 microglandular hyperplasia of the cervix, atypical squamous metaplasia of the cervix, 2 cervical endomeriosis, 2 tubal metaplasia, 10 cervical myoma, 11 cervical polyps, endometrial polyps, 3 uterine myoma, 1 pelvic endometriosis, 1 varian endometriosis, and 4 uterine adenomyosis. The premaligant or malignant lesions of the cervix were 4 low-grade squamous ntraepithelial lesions, 24 high-grade squamous intraepithelial leions, 8 glandular atypia/dysplasia, 5 adenocarcinoma in situ, 3 icroinvasive adenocarcinoma, and 4 invasive adenocarcinoma. he neoplastic lesions of the uterus were 6 endometrial hyperplaia, 11 endometrial adenocarcinoma, 1 malignant mixed Mullerian umor, and 1 metastatic endometrial adenocarcinoma. Sixty-seven 25%) of 268 patients followed up were identified as having clincally significant lesions of the cervix or uterus. The detection rates f abnormal lesions were 3.1% with repeated Pap smears (3/98), 8.4% with colposcopic-directed biopsy (31/109), 63.6% with cone iopsy (35/55), and 29.7% with endometrial curettage (19/64). Conclusion. AGUS on Pap smears showed various benign and alignant lesions of the cervix or uterus. The clinicians must ommunicate with the pathologists regarding the patient’s clinical