Behtash N, Fakhrejahani F, Khafaf A, Ghayouri Azar E,
Volume 65, Issue 3 (2 2007)
Abstract
Background: The aim of this study was to evaluate the association between atypical glandular cell (AGC) on Pap smear and significant pathologic finding to tailor management protocols.
Methods: Between 2002 and 2005, Among 26893 Pap smears 122 women with AGC Pap smears (prevalence=0.45%) were referred to our colposcopy clinic. Forty one women underwent colposcopy directed biopsy, endocervical curettage, endometrial sampling and cervical conization to determine the cytologic and histologic correlations of AGC on pap smears.
Results: A total of 122 women with AGC Pap smear were found. Only 41 women accepted to participate in the study and followed the workup procedures. The mean age of the patients was 46.92 ±11.48 years (range, 23-80 years). Of these patients 13 patients (31.7%) were post menopause and 28 patients (68.2%) were in reproductive age.
We found 13 (31.7%) significant pathologic findings including 4 (9.7%) high grade squamous intraepithelial lesion (HG-SIL), 3(7.3%) low grade squamous intraepithelial lesion (LG-SIL), 2(4.8%) Endometrial hyperplasia, 1(2.4%) Endometrial adenocarci-noma, 1(2.4%) adenocarcinoma of cervix, 1(2.4%) squamous cell carcinoma of cervix and 1(2.4%) papillary serous tumor of ovary. There was not any significant difference in the prevalence of significant pathologic findings and subtype of squamous or adenomatous lesions between pre and postmenopausal group.
Conclusion: AGC on Pap smear was associated with a clinically significant diagnosis in approximately one third of our cases. The women with a diagnosis of AGC on cervicovaginal smear are needed to be evaluated at least with colposcopy, endocervical and endometrial curettage. Clinicians should be careful about the significance of AGC in pap smears.
