Atypical glandular cells of undetermined significance. Cytologic predictive value for glandular involvement in high grade squamous intraepithelial lesions.
OBJECTIVE
To verify the cytologic predictive value of a diagnosis of atypical glandular cells of undetermined significance (AGUS) in high grade squamous intraepithelial lesions (HSIL) cases.


METHODS
In a retrospective study, 98 cases of HSIL were reviewed. All patients were referred for colposcopy and directed biopsy to confirm the cytologic diagnoses. Loop excision of the transformation zone was performed to treat clinical lesions. Sensitivity, specificity, positive and negative predictive value were evaluated. Kappa statistics and logistic regression analysis were used to evaluate the findings statistically.


RESULTS
By logistic regression analysis, we found that the chance of finding squamous intraepithelial lesions involving glands in AGUS smears was 5.32 times higher than in those with no AGUS. It was 5.74 times higher in cervical intraepithelial neoplasia (CIN) 3 lesions than in CIN 2.


CONCLUSIONS
The cytologic predictive value for HSIL involving glands is statistically significant when specific and objective criteria are used for the AGUS diagnosis.
Mattośinho de Castro Ferraz
Maria Da Gloria
Mda G
Departments of Gynecology and Pathology, Federal Univesity of São Paulo-Escola Paulista de Medicina, São Paulo, Brazil. gmattosinho@uol.com.br
Focchi
José
J
Stavale
João Norberto
JN
Nicolau
Sérgio Mancini
SM
Rodrigues de Lima
Geraldo
G
Baracat
Edmund Chada
EC
D000230:Adenocarcinoma / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D002584:Cervix Uteri / Q000473:pathology*; D003937:Diagnosis, Differential; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D006801:Humans; D008403:Mass Screening; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000473:pathology*