Atypical glandular cells: criteria to discriminate benign from neoplastic lesions and squamous from glandular neoplasia.
OBJECTIVE
To evaluate the presence of some criteria in cervical smears with atypical glandular cells and their correlation with histological patterns to identify pre-neoplastic and neoplastic lesions.


METHODS
Seventy-three women referred with an atypical glandular cell smear, who had undergone conization or hysterectomy, were included in this study. Referral Pap smears were reviewed using the set of 27 cyto-morphological criteria that was correlated with the histological diagnosis.


RESULTS
Histological results showed intraepithelial or invasive neoplasia in 35 (48%) cases and benign lesions in 38 (52%) cases. After logistic regression and decision tree analysis an increased nuclear/cytoplasmic ratio and the presence of dyskeratotic cells were strongly associated with intraepithelial or invasive neoplasia and the differential cyto-morphological criteria for glandular lesions were decreased cytoplasm, irregular nuclear membranes and the presence of nucleoli.


CONCLUSIONS
The analysis of individual cyto-morphological criteria can better predict intraepithelial or invasive neoplasia and differentiate glandular from squamous lesions.
Torres
J C C
JC
Department of Obstetrics and Gynaecology and Pathology, Universidade de Campinas (UNICAMP), Sao Paulo, Brazil.
Derchain
S F M
SF
Gontijo
R C
RC
do Amaral Westin
M C
MC
Zeferino
L C
LC
Angelo-Andrade
L A L
LA
Rabelo-Santos
S H
SH
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D002584:Cervix Uteri / Q000473:pathology*; D003430:Cross-Sectional Studies; D003581:Cytodiagnosis / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D065006:Papanicolaou Test; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000473:pathology*