Clinical significance of atypical glandular cells of undetermined significance in postmenopausal women

Citation
Dc. Chhieng et al., Clinical significance of atypical glandular cells of undetermined significance in postmenopausal women, CANC CYTOP, 93(1), 2001, pp. 1-7
Citations number
28
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Oncology,"Onconogenesis & Cancer Research
Journal title
CANCER CYTOPATHOLOGY
ISSN journal
0008-543X → ACNP
Volume
93
Issue
1
Year of publication
2001
Pages
1 - 7
Database
ISI
SICI code
0008-543X(20010225)93:1<1:CSOAGC>2.0.ZU;2-E
Abstract
BACKGROUND. Glandular atypia in Papanicolaou (Pap) smears from postmenopaus al women is encountered frequently. This finding can be the result of artif actitious alterations such as drying artifacts and inflammatory changes or map represent a squamous or glandular, preneoplastic or neoplastic process. Therefore, it is important to determine the clinical implication of a diag nosis of atypical glandular cells of undetermined significance (AGUS) in po stmenopausal patients. METHODS. A total of 30,036 Pap smears were obtained from postmenopausal wom en between 1995 and 1997. Among these smears, 154 (0.51%) had a diagnosis o f AGUS. Follow-up was available for 133 patients (86.4%); 110 patients (82. 7%) had histologic follow-up (including cervical biopsy, endocervical [EC] curettage, and/or endometrial [EM] biopsy) and 23 patients (17.3%) had repe at smears. RESULTS. Thirty-six of 110 patients (32.7%) were found to have a clinically significant lesion (defined as a preneoplastic or neoplastic, glandular or squamous lesion) on subsequent histologic follow-up. Nineteen patients (53 %) had glandular lesions (15 EM adenocarcinoma [ACA] cases, 2 EC ACA cases, 1 EC adenocarcinoma is situ case, and 1 EM hyperplasia case). Seventeen pa tients (47%) had a squamous intraepithelial lesion (SIL) (6 cases of low-gr ade SIL, 9 cases of high-grade [HGIL], and 2 cases of squamous cell carcino ma). Among those patients with repeat Pap smears, five patients had persist ent AGUS/atypical squamous cells of undetermined significance and one patie nt had an SIL. CONCLUSIONS. The incidence of AGUS among postmenopausal patients was simila r to that of the general population (0.51% vs. 0.56%; P > 0.05). A signific ant percentage of these patients were found to have a clinically significan t lesion on subsequent follow-up. Furthermore, a majority of these lesions were ACA (53%) or HGSIL (26%). The findings of the current study strongly s uggest the need for the close follow-up of postmenopausal patients with a d iagnosis of AGUS. Cancer (Cancer Cytopathol) 2001;93:1-7. (C) 2001 American Cancer Society.