Analyses of atypical glandular cells re-defined by the 2006 Bethesda System: histologic outcomes and clinical implication of follow-up management.
BACKGROUND
To evaluate the histopathology and the long-term follow-up outcome of women who had atypical glandular cells on Pap smears.


METHODS
All women with atypical glandular cells (AGC) who underwent colposcopic and histopathologic evaluation between January 2005 and October 2010 were reviewed. Patient data were examined up to October 2012, allowing for at least two years of follow-up for all patients.


RESULTS
Forty-four women with AGC Pap test underwent histologic follow-up during the study period. Overall, upon reclassification of smears, 35 (79.5%) cases were diagnosed with AGC "not otherwise specified" (NOS) and nine (20.5%) with AGC "favour neoplasia". Seven out of nine patients (77.7%) with AGC "favour neoplasia" had significant pathology. On the other hand, only 11 out of 35 cases (31.4%) with AGC "NOS" had significant pathology. Significant correlation was found between AGC "favour neoplasia" smears and a significant pathology (p: 0.01). Of the 44 patients, 18 (40.9%) had significant pathology. Eight patients (18.2%) had low grade cervical intraepithelial neoplasia (CIN 1), four (9%) had high-grade cervical intraepithelial neoplasia (CIN 2/3), one (2.2%) had microinvasive squamous cell carcinoma of uterine cervix, one (2.2%) had cervical adenocarcinoma in situ, one (2.2%) had cervical adenocarcinoma, one (2.2%) had endometrial adenocarcinoma, and two (4.5%) had endometrial hyperplasia.


CONCLUSIONS
Reporting AGC in the population is clinically significant due to the high prevalence of underlying preinvasive and invasive diseases (40.9%). The subtypes of the AGC category are significant predictor of such lesions.
Department of Obstetrics and Gynecology, Oncology Unit, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey. drvolkanulker@yahoo.com
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Ulker
Department of Obstetrics and Gynecology, Oncology Unit, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey.
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Numanoglu
Department of Obstetrics and Gynecology, Kanuni Sultan Siileyman Training and Research Hospital, Istanbul, Turkey.
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Akyol
Department of Obstetrics and Gynecology, Kanuni Sultan Siileyman Training and Research Hospital, Istanbul, Turkey.
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Kuru
Department of Obstetrics and Gynecology, Oncology Unit, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey.
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Akbayir
Department of Pathology, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey.
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Erim
Department of Pathology, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey.
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Ongut
D000328:Adult; D000367:Age Factors; D002584:Cervix Uteri / Q000473:pathology*; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000302:isolation & purification; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis
D004279:DNA, Viral