Monti Ermelinda, Di Loreto Eugenia, Libutti Giada, Alberico Daniela, Barbara Giussy, Boero Veronica, Cetera Giulia Emily, Pasquali Coluzzi Maria, Cipriani Sonia, Parazzini Fabio
Dipartimento Materno-Infantile, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico.
Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Milan, Italy.
Eur J Cancer Prev. 2025 Mar 1;34(2):106-112. doi: 10.1097/CEJ.0000000000000910. Epub 2024 Nov 5.
'Atypical glandular cells' (AGC) is an uncommon cytological result of cervical Pap smears which includes a wide of histopathological diagnoses, from benign to premalignant and malignant cervical disorders, endometrial cancer and, occasionally, other genital malignancies. This study aims to provide a comprehensive overview of AGC, assessing risk factors and clinical and histological features in affected patients.
A retrospective analysis was conducted on a cohort of 239 women diagnosed with AGC between 2012 and 2022 at the 'Regional Referral Center for Prevention, Diagnosis and Treatment of HPV-related Genital Disorders', Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. Following AGC detection, patients underwent colposcopy with endocervical sampling and endometrial assessment via pelvic ultrasound. Selective cases also received endometrial biopsies.
Among a total of 190 women who underwent both colposcopy and endometrial assessment, 116 (61%) had negative clinical and histopathological findings. The remainder displayed various abnormalities: 36 women (18.9%) were found to have endometrial or cervical polyps, 23 (12.1%) were diagnosed with preinvasive cervical neoplasia, and 21 (10.9%) with invasive cervical or endometrial disease. Menopause, multiparity, and older age were all significantly associated with endometrial cancer, but none of the abovementioned variables were significantly associated with cervical neoplasia.
Our data confirm that AGC may reveal the presence of a wide range of histopathological conditions. Patients diagnosed with AGC should undergo a careful evaluation including both colposcopy with endocervical sampling and an endometrial assessment.
“非典型腺细胞”（AGC）是宫颈巴氏涂片检查中一种不常见的细胞学结果，涵盖了广泛的组织病理学诊断，包括良性、癌前及恶性宫颈疾病、子宫内膜癌，偶尔还包括其他生殖器恶性肿瘤。本研究旨在全面概述AGC，评估受影响患者的危险因素以及临床和组织学特征。
对2012年至2022年间在意大利米兰的Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico的“HPV相关生殖器疾病区域预防、诊断和治疗转诊中心”诊断为AGC的239名女性队列进行了回顾性分析。检测到AGC后，患者接受了阴道镜检查及宫颈管取样，并通过盆腔超声进行子宫内膜评估。部分病例还接受了子宫内膜活检。
在总共190名接受了阴道镜检查和子宫内膜评估的女性中，116名（61%）临床和组织病理学检查结果为阴性。其余患者表现出各种异常：36名女性（18.9%）被发现患有子宫内膜或宫颈息肉，23名（12.1%）被诊断为宫颈原位癌，21名（10.9%）患有浸润性宫颈癌或子宫内膜癌。绝经、多产和高龄均与子宫内膜癌显著相关，但上述变量均与宫颈肿瘤无显著关联。
我们的数据证实，AGC可能提示多种组织病理学状况的存在。诊断为AGC的患者应接受仔细评估，包括阴道镜检查及宫颈管取样和子宫内膜评估。
