Salomão Diva R, Hughes Jonathan H, Raab Stephen S
Department of Pathology, University of Iowa, Iowa City, Iowa, USA.
Acta Cytol. 2002 May-Jun;46(3):458-64. doi: 10.1159/000326861.
To evaluate cytologic criteria for separating atypical glandular cells of undetermined significance favor endometrial origin (AGUS-EM), on Papanicolaou-stained (Pap) smears into favor benign and favor malignant categories.
All patients who had a Pap smear diagnosis of AGUS-EM, not further qualified, followed by tissue follow-up were identified from the surgical pathology and cytopathology files from January 1992 through December 1996. The Pap smears were scored blindly for the presence or absence of 40 cytologic criteria, and univariate analysis was performed to determine which criteria were most indicative of malignancy by tissue follow-up.
The presence of an atrophic smear, nuclear size greater than twice that of an intermediate cell nucleus and absence of clusters with irregular borders were highly indicative of adenocarcinoma, although other criteria were also helpful in identifying malignancy.
There are no combinations of cytologic criteria that definitely separate AGUS-EM cases into those with benign or malignant findings on follow-up. However, some isolated criteria were useful in the differential diagnosis in a [table: see text] significant number of cases.
评估在巴氏染色涂片上，将意义不明确的非典型腺细胞（倾向于子宫内膜来源，AGUS-EM）分为良性倾向和恶性倾向类别的细胞学标准。
从1992年1月至1996年12月的手术病理和细胞病理档案中，识别出所有巴氏涂片诊断为AGUS-EM且未进一步明确诊断、随后进行组织随访的患者。对巴氏涂片盲目评分，看是否存在40项细胞学标准，并进行单变量分析，以确定哪些标准通过组织随访最能提示恶性病变。
存在萎缩性涂片、核大小大于中层细胞核的两倍以及不存在边界不规则的细胞团高度提示腺癌，尽管其他标准在识别恶性病变方面也有帮助。
没有哪组细胞学标准能明确地将AGUS-EM病例分为随访时有良性或恶性结果的病例。然而，一些单独的标准在相当数量的病例的鉴别诊断中是有用的。
