Clinicopathologic Significance of Atypical Glandular Cells in Cervical Cytology Smears: A five years Retrospective Study in a Tertiary Care Hospital

Abstract

Introduction: Cervical cancer is the fourth most common cancer among women. Recently the incidence of cervicaladenocarcinoma has been increased significantly on the contrary to the decreasing incidence of cervical squamouscell carcinoma. Routine screening of cervical cancer by cervical smear cytology study to detect the pre-invasivelesions carries a significant role in reducing the incidence and mortality rate of cervical cancer.Objective: The aim of our study was to analyze the prevalence of Atypical Glandular Cells (AGCs) detected incervical smear screening, the follow up histopathological outcome and their clinical significance.Materials and Methods: This was a retrospective study done in College of Medicine and Sagore Dutta Hospital,Kolkata over a period of 5 years from June 2017 to June 2022. Patients detected with Atypical Glandular cells(AGCs) in cervical smears and having records of follow up histopathology reports were included in this study.The cases of AGCs in which the follow up histopathological reports were not available were excluded from thestudy.Result: The prevalence of atypical glandular cells were 0.57%. Out of the total 10,950 cervical smears examinedAGCs were found in 63 cases (0.57%). Out of 63 cases of AGCs subcategorization was done(according to TBS2015) which showed AGC not otherwise specified (AGC-NOS) in 46 cases (0.43%) and AGC Favoring Neoplasia(AGC-FN) were seen in 15 cases (0.13%). Both AGC -NOS and AGC-FN showed various pathology ranging fromreactive, metaplastic, benign to, in situ/Invasive carcinomas.Discussion: One of the major concern of AGC is that the cytological findings which characterize it have poorreproducibility between observers leading to interobserver variability. Due to the reported risk of premalignantand malignant lesions in AGCs it bear a great clinical significance and need for further histopathological correlation.
 Conclusion: Due to very low incidence of AGCs and the risk of malignancy associated with it multiple histologicalevaluation methods required for earlier diagnosis and management of the malignancies detected on histologicfollow up