title: Significance of the cytologic diagnosis of endocervical glandular involvement in high-grade squamous intraepithelial lesions.
abstract: The cytologic criteria for the diagnosis of endocervical gland involvement (EGI) by high-grade squamous intraepithelial lesions (HGSILs) have been described, and this diagnosis occasionally is made. This study evaluates the accuracy of a cytologic diagnosis compared with that of follow-up cone biopsies. Twenty-eight patients with Papanicolaou (Pap) smear diagnoses of HGSILs with EGI, with follow-up cone biopsies, were identified from New York University computerized files. Results were compared with those of a control group of 28 patients showing cervical intra-epithelial neoplasia grades II/III (CIN-II/III), irrespective of previous Pap smear findings. On subsequent cone biopsy samples, 26 of the 28 study cases showed signs of HGSIL. Of these 26 patients, 17 (65%) showed evidence of HGSIL with EGI. Among the 28 control cases, 20 (71.4%) had EGI on the cone biopsies (P = NS). We also examined previous Pap smear findings in a control group of 42 cone biopsies with CIN-II or CIN-III, with or without EGI. EGI was diagnosed in previous Pap smears in 3 of the 31(10%) cases that showed signs of EGI on cone biopsies and in 2 of the 11 cases (18%) that did not evidence EGI on subsequent cone biopsies (P = NS). In our experience, the cytologic diagnosis of EGI on Pap smears did not identify a group of patients with increased frequency of EGI on subsequent cone biopsies.
authors.affiliation: Department of Pathology, New York University School of Medicine and Kaplan Comprehensive Cancer Center, New York, New York 10016, USA. pascale.levine@med.nyu.edu
authors.forename: Pascale Hummel
authors.initials: PH
authors.lastname: Levine
authors.forename: Jerry
authors.initials: J
authors.lastname: Waisman
authors.forename: Khush
authors.initials: K
authors.lastname: Mittal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002584:Cervix Uteri / Q000473:pathology*; D003581:Cytodiagnosis / Q000379:methods*; D005088:Exocrine Glands / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D015203:Reproducibility of Results; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D002578:Uterine Cervical Dysplasia / Q000145:classification / Q000473:pathology*