Keles Esra, Ozturk Ugur K, Alınca Cihat M, Giray Burak, Kabaca Canan, Cetiner Handan
Department of Gynecologic Oncology, Zeynep Kamil Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey.
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Koc University School of Medicine, Istanbul, Turkey.
J Cytol. 2021 Oct-Dec;38(4):210-215. doi: 10.4103/JOC.JOC_54_21. Epub 2021 Nov 12.
Glandular cell abnormalities may indicate the presence of pre-malignant or malignant lesions.
This study aimed to investigate the relationship between atypical glandular cells (AGC) and patients' demographics, histopathological outcomes, Human Papillomavirus (HPV) test results.
Between January 2015 and December 2019, women with AGC on Pap tests were retrieved from the hospital electronic database. The patients with AGC on cervicovaginal smears who underwent further pathological, laboratory, and imaging diagnostic testing and who were followed up at least 1-year were included in the study, while those who had a history of cervical dysplasia or cancer, lost during follow-up, or had missing data were excluded.
Of 85,692 Pap smears, 114 (0.13%) were diagnosed with AGC, of those 88 cases were eligible for final analysis. Gynecological malignancies were detected in 13 (14.8%) patients; including 6 (6.8%) endometrioid endometrial cancers, 3 (3.4%) non-endometrioid endometrial cancers, 2 (2.3%) cervical adenocarcinomas, 1 (1.1%) cervical squamous cell carcinoma, and 1 (1.1%) high-grade tubal serous cancer. Multivariate analysis revealed that presence of concomitant abnormal squamous lesion ( = 0.002), being 50 years and older ( = 0.028), HPV positivity ( < 0.001), and menopause ( = 0.023) were risk factors for significant pathology.
The diagnosis of AGC may be related to the preneoplastic/neoplastic processes. A further comprehensive histopathological examination is required in women with AGC, aged 50 years and older, postmenopausal, HPV-positivity and concomitant squamous cell abnormality Clinicians should consider ovarian pathologies when there is no pathological finding on endometrial or cervical histopathological examination.
腺细胞异常可能提示存在癌前或恶性病变。
本研究旨在探讨非典型腺细胞（AGC）与患者人口统计学特征、组织病理学结果、人乳头瘤病毒（HPV）检测结果之间的关系。
2015年1月至2019年12月期间，从医院电子数据库中检索出巴氏试验显示AGC的女性。纳入在宫颈阴道涂片检查中发现AGC并接受了进一步病理、实验室和影像学诊断检查且至少随访1年的患者，排除有宫颈发育异常或癌症病史、随访期间失访或有缺失数据的患者。
在85692例巴氏涂片检查中，114例（0.13%）被诊断为AGC，其中88例符合最终分析条件。13例（14.8%）患者检测出妇科恶性肿瘤；包括6例（6.）子宫内膜样子宫内膜癌、3例（3.4%）非子宫内膜样子宫内膜癌、2例（2.3%）宫颈腺癌、1例（1.1%）宫颈鳞状细胞癌和1例（1.1%）高级别输卵管浆液性癌。多因素分析显示，同时存在异常鳞状病变（P = 0.002）、年龄50岁及以上（P = 0.028）、HPV阳性（P < 0.001）和绝经（P = 0.023）是显著病理改变的危险因素。
AGC的诊断可能与癌前/肿瘤形成过程有关。对于年龄50岁及以上、绝经后、HPV阳性且同时存在鳞状细胞异常的AGC女性，需要进行进一步全面的组织病理学检查。当子宫内膜或宫颈组织病理学检查未发现病理改变时，临床医生应考虑卵巢病变。
