Endocervical atypical glandular cells of undetermined significance. I. Morphometric and cytologic characterization of cases that "cannot rule out adenocarcinoma in situ".
OBJECTIVE
To determine whether evaluating morphologic features through morphometry and cytology can lead to a more-satisfactory characterization of endocervical atypical glandular cells of undetermined significance (AGUS) cases that "cannot rule out adenocarcinoma in situ" (AIS).


METHODS
Fifty-seven endocervical AGUS cases showing incomplete criteria of AIS were morphometrically compared to five smears with normal endocervical columnar cells (ECC) and to five histologically confirmed endocervical adenocarcinoma cases. For each atypical nucleus, the area and shape were measured. Twenty-five cytologic criteria were used to review the AGUS and neoplastic smears.


RESULTS
AGUS nuclei showed an intermediate value in terms of area and shape as compared to the values of normal and neoplastic nuclei. In particular, AGUS nuclear enlargement (136.626 micron 2) was about twice the area of normal nuclei and half the value of the area of neoplastic nuclei (P < .0000). AGUS nuclei also had the greatest variability in size and shape, indicating that anisonucleosis may be a morphologic discriminator of endocervical AGUS. The cytologic features useful in discriminating AGUS from neoplastic smears were: presence of normal ECCs, singly or in sheets (P < .001); absence of necrosis (P < .001); bare atypical cells (P < .001); papillary groups (P < .01); anisonucleosis (P < .05); irregular chromatin distribution (P < .05); and hyperchromasia (P < .01).


CONCLUSIONS
Morphometry and cytology led to a better characterization of endocervical AGUS cases that "cannot rule out AIS."
Cenci
M
M
Department of Experimental Medicine and Pathology, Rome University La Sapienza, Italy.
Mancini
R
R
Nofroni
I
I
Vecchione
A
A
D000230:Adenocarcinoma / Q000145:classification / Q000473:pathology*; D002278:Carcinoma in Situ / Q000145:classification / Q000473:pathology*; D002467:Cell Nucleus / Q000473:pathology; D002584:Cervix Uteri / Q000166:cytology*; D005260:Female; D006801:Humans; D002583:Uterine Cervical Neoplasms / Q000145:classification / Q000473:pathology*