Management of atypical glandular cells of undetermined significance pap smears: a reappraisal.
OBJECTIVE.: To find appropriate management of patients with atypical glandular cells of undetermined significance (AGUS) Pap smears. MATERIALS AND METHODS.: The authors present their findings on patients with 606 AGUS Pap smears based on colposcopy, cervical biopsies, endocervical curettage, and endometrial biopsy. Twenty-one proposed management schemes by other authors are reviewed. RESULTS.: From 606 AGUS Pap smears, 69% had benign findings and 31% had neoplastic findings. Among 29 patients with endometrial pathology, only 4 patients (14%) were <40 years old. All proposed management schemes were uniform in the use of colposcopy but differed on the selective use of endometrial biopsy. CONCLUSION.: An AGUS Pap smear requires colposcopy. We suggest endometrial biopsy for women over 40 years old and for women younger than 40 years old who have a high risk for endometrial neoplasia. Better-defined cytologic criteria from cytologists are needed.
Van Dinh
Tung
T
Divisions of 1Gynecologic Oncology and 2Reproductive Endocrinology, Department of Obstetrics & Gynecology, University of Texas Medical Branch, Galveston, TX.
Haque
Moona
M
Lucci
Joseph A
JA
Smith
Edward R
ER
Hannigan
Edward V
EV