Clinical Implication of a Typical Glandular Cells; a Five Years Experience of a Single Institution in Portugal

Abstract

Objective: The study aimed to evaluate the clinical significance of atypical glandular cells (AGC) in cervical cytological reports and its correspondent subtypes. Material and methods: Retrospective study of AGC cervical cytological diagnoses, from January 2009 to December 2013, at a tertiary centre. A global analysis of AGC and its correspondent subtypes was performed, according to age, onset of sexual life, Human Papilloma Virus deoxyribonucleic acid (HPV-DNA) status, diagnostic procedures and follow-up histological outcomes. Results: Cervical AGC cytology had a prevalence of 0.3% among women with an average age of 46.8 ± 14.5 years. The distribution showed 81% of AGC-not otherwise specified (AGC-NOS) and 10.7% of AGC-favor neoplastic (AGC-FN). AGC-NOS had a higher prevalence of benign pathology. AGC-FN showed an association to in situ adenocarcinoma, a superior incidence of endometrial carcinoma and a tendency towards a higher prevalence of squamous cervical intraepithelial neoplasia. Glandular and squamous coexisting cytological abnormalities accounted for 8.3% and were mostly associated with squamous lesion. HPV-DNA testing demonstrated a sensitivity of 50% with a specificity of 100% for detection of cervical lesions. Discussion: Close follow-up of AGC is required once pre-malignancy and malignant disease was identified in 20.8% of patients. A precise study of cervix and endometrium assumes equal importance, significant pathology was found in both locations.