Abstract
Objective:To analyze the histopathologic outcomes of patients with atypical glandular cells (AGC) in cervicovaginal cytology examinations.Material and Methods:Patients with AGC in cervicovaginal cytology were included in this study between March 2011 and March 2018 and patient data were collected retrospectively among all cytology results. AGC classification of cervicovaginal cytology were based on the Bethesda 2001 classification system.Results:The total prevalence of cervical epithelial cell abnormality and AGC were found as 4.2% and 0.2%, respectively, in the study cohort. AGC-favor neoplasia (AGC-FN) was the subgroup of AGC with the highest malignancy rate with 62.5% (p=0.06). The incidence of malignancy in the postmenopausal group (33.3%) was detected higher than in the premenopausal group (8.3%) (p=0.07).Conclusion:The probability of malignancy in AGC-FN cytology is more commonly associated with malignancy in the postmenopausal group. Therefore, histopathologic examination is strongly recommended in these patients with AGC smears because of the high risk for malignancy in this group.
Highlights
Preinvasive lesions of the cervix can be diagnosed with Papanicolaou smear tests and be treated long before overt carcinoma develops
A thorough understanding of cervical cancer pathogenesis and the development of effective screening programs both with cervical cytology and human papilloma virus (HPV) typing and vaccination against high-risk HPV types have significantly altered the distribution of cervical cancer and premalignant lesions of the cervix in countries where screening programs cover the majority of the population
The evaluation based on subtypes of atypical glandular cell (AGC) revealed AGC-not otherwise specified (AGC-NOS), AGC-endocervical cells (AGC-EC), AGC-endometrial cells (AGC-EM), and AGC-favor neoplasia (AGC-FN) in 17 (32.6%), 23 (44.2%), 2 (3.8%), and 10 (19.2%) of patients, respectively (Table 1)
Summary
Preinvasive lesions of the cervix can be diagnosed with Papanicolaou smear tests and be treated long before overt carcinoma develops. Routine cervical cancer screening programs in many countries significantly reduced the incidence and mortality rate of cervical cancer [1]. A thorough understanding of cervical cancer pathogenesis and the development of effective screening programs both with cervical cytology and human papilloma virus (HPV) typing and vaccination against high-risk HPV types have significantly altered the distribution of cervical cancer and premalignant lesions of the cervix in countries where screening programs cover the majority of the population. The incidence of squamous cell cancers of the cervix is decreasing, the rate of adenocarcinomas among cervical cancers is either unchanged or increasing [2]. The incidence of atypical glandular cell (AGC) was reported as 0.17% in a recent large study on cervical cytologic screening [4].
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