Diaz-Montes Teresa P, Farinola Maryam Armin, Zahurak Marianna L, Bristow Robert E, Rosenthal Dorothy L
The Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, The Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.
Gynecol Oncol. 2007 Feb;104(2):366-71. doi: 10.1016/j.ygyno.2006.09.001. Epub 2006 Oct 16.
To determine the utility of the category of atypical glandular cells (AGC) in the management of patients with putative cervical neoplasia and to correlate HPV-DNA test results when available.
The Johns Hopkins Hospital cytopathology records of 50,668 women patients were searched for all liquid-based gynecologic cytology (LBP) results of Atypical Glandular cells of Undetermined Significance (AGUS) and AGC from January 1, 2001 through December 31, 2003, yielding 98 patients (0.19%). Oncogenic HPV-DNA tests were performed on the residual fluids of 43 of these patients, 37 of whom had follow-up biopsy. During the period of January 1, 2000 and December 31, 2002, we identified 237 patients (0.58%) with conventional Pap smears in the AGUS or AGC category, among 41,024 conventional smears collected contemporaneously. To avoid confusion in this paper, AGC will be used to replace those results that originally were AGUS.
Following the 98 LBP AGC interpretations, 24 lesions (33.8%) were discovered out of 71 biopsies. HPV-DNA tests were performed on the residual of 43 LBPs, 18 (41.9%) were positive for oncogenic HPV. Only 37 patients had follow-up biopsy and 15 (40.5%) were positive for oncogenic HPV, of which 40% (6/15) had a significant lesion. Of the 237 conventional AGC Paps, 18 lesions (15.3%) were discovered out of 118 biopsies.
Comparison of liquid-based and conventional Pap tests revealed a significant difference (33.8% vs. 15.3% respectively) (OR: 2.84, 95% CI: 1.4-5.73, p=0.004) in the detection of glandular and squamous lesions. HPV testing may prove beneficial to triage AGC patients with negative colposcopic findings and positive HPV results.
确定非典型腺细胞（AGC）类别在疑似宫颈肿瘤患者管理中的效用，并在可行时关联HPV-DNA检测结果。
检索约翰霍普金斯医院50668名女性患者的细胞病理学记录，查找2001年1月1日至2003年12月31日期间所有意义不明确的非典型腺细胞（AGUS）和AGC的液基妇科细胞学（LBP）结果，共98例患者（0.19%）。对其中43例患者的残余液体进行了致癌性HPV-DNA检测，其中37例进行了后续活检。在2000年1月1日至2002年12月31日期间，在同期收集的41024份传统巴氏涂片检查中，我们识别出237例（0.58%）处于AGUS或AGC类别的传统巴氏涂片检查患者。为避免本文混淆，AGC将用于替代那些原本为AGUS的结果。
在98次LBP AGC解读后，71次活检中发现24个病变（33.8%）。对43次LBP的残余物进行了HPV-DNA检测，18次（41.9%）致癌性HPV呈阳性。仅37例患者进行了后续活检，15例（40.5%）致癌性HPV呈阳性，其中40%（6/15）有显著病变。在237例传统AGC巴氏涂片检查中，118次活检中发现18个病变（15.3%）。
液基和传统巴氏试验的比较显示，在腺性和鳞状病变检测方面存在显著差异（分别为33.8%和15.3%）（OR：2.84，95%CI：1.4 - 5.73，p = 0.004）。HPV检测可能有助于对阴道镜检查结果阴性且HPV结果阳性的AGC患者进行分流。
