Clinical significance of atypical glandular cells on Pap smears: experience from a region with a high incidence of cervical cancer.

AIM

To evaluate the histopathology of women who had atypical glandular cells (AGC) on Pap smears in a region with high incidence of cervical cancer.

MATERIAL AND METHODS

This study was conducted at Chiang Mai University Hospital, Chiang Mai, Thailand. All women with AGC who underwent colposcopic and histopathologic evaluation between January 2002 and December 2008 were reviewed. Women with simultaneous diagnosis of squamous cell abnormality or prior history of cancer of any type were excluded.

RESULTS

Sixty-three women with AGC Pap test had histologic follow-up during the study period. Mean age was 44.9 years (range, 31-72 years). Six (9.5%) women were nulliparous. Sixteen (25.4%) women were postmenopausal. The histopathologic results of these 63 women were as follows: cervical intraepithelial neoplasia (CIN) 2-3, 5 (7.9%); adenocarcinoma in situ (AIS), 3 (4.8%); endometrial cancer, 3 (4.8%); cervical cancer, 2 (3.2%); endometrial hyperplasia (EH), 1 (1.6%); and no lesions, 49 (77.8%). The prevalence of significant lesions (CIN 2-3, AIS, EH, and cancer) in women with atypical glandular cells, favor neoplasia (AGC-FN) was significantly higher than that in the atypical glandular cells, not other specified (AGC-NOS) group (41.2% and 15.2%, P = 0.02).

CONCLUSION

Reporting AGC in our population is clinically significant due to the high prevalence of underlying preinvasive and invasive diseases (22.2%). This subtype of the AGC category is a significant predictor of such lesions.