A retrospective review on atypical glandular cells of undetermined significance (agus) using the Bethesda 2001 classification

Tam, Kwok-kan; Cheung, Annie N.Y.; Liu, K.L; Ng, TY; Pun, Ting-Chung; Yw, Chan; Wong, LC; Ng, Anita W. Y.; Ngan, Hextan Y.S.

doi:10.1016/j.ygyno.2003.08.029

Cited by 57 publications

(51 citation statements)

References 7 publications

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“…12,13,[17][18][19] The changing concepts of these glandular lesions led the 2001 Bethesda classification to refine the diagnostic categories, making AIS its own entity and replacing atypical glandular cells of undetermined significance by "glandular cells, favor neoplastic." 20 Unfortunately, however, this new nomenclature has not solved the basic problem, how to improve the accuracy of cytologic diagnosis of cervical AC and its precursor lesions. 8,12,13,[18][19][20][21] With increasing evidence suggesting the etiolog- ic role of oncogenic human papillomaviruses (HPVs) in cervical AC, 8,22 the recent past has witnessed an influx of reports implicating the utility of HPV testing in the diagnosis of AIS, AC and their precursors.…”

Section: Editorialmentioning

confidence: 99%

Is Improved Detection of Adenocarcinoma in Situ by Screening a Key to Reducing the Incidence of Cervical Adenocarcinoma?

Syrjänen¹

2004

Acta Cytologica

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Section: Editorialmentioning

confidence: 99%

Is Improved Detection of Adenocarcinoma in Situ by Screening a Key to Reducing the Incidence of Cervical Adenocarcinoma?

Syrjänen¹

2004

Acta Cytologica

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“…The mean age of patients having AGUS during pregnancy or postpartum period was only available in one of the papers discussed above. The mean age of these patients was much lower (mean age=27) than in non-pregnant populations (ages 44 to 50), 6,9,10,12 and could partially explain the lower incidence of significant pathology in pregnancy-related AGUS as the risk of malignancy is lower in younger women.…”

mentioning

confidence: 87%

“…From the studies described above, the incidence of significant pathology following an abnormal glandular cytology on cervical smear during pregnancy or postpartum period was not as high as has been demonstrated in the non-pregnant population (31% to 48%). 4,10,11 The observed lower incidence could be explained by 1) over-diagnosis of AGUS during pregnancy and postpartum period, and 2) younger age in patients having pregnancy-related AGUS smears. A number of reports have emphasized pregnancy-related cellular changes and their diagnostic pitfalls.…”

mentioning

confidence: 97%

Atypical Glandular Cells in Cervical Smear During Pregnancy and Postpartum Period

Tam¹

2005

Clinical Medicine & Research

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The 2001 Bethesda System defines atypical glandular cells (AGC) as glandular cell abnormalities that are distinct from adenocarcinoma or adenocarcinoma in situ. 1 Before 2001, a spectrum of glandular cell abnormalities in cervical smears was grouped under atypical glandular cells of undetermined significance (AGUS) and defined as glandular cells exhibiting changes beyond reactive or reparative changes, but lacking unequivocal features of invasive adenocarcinoma. 2 The incidence and clinical significance of AGUS have been extensively reported, 3-6 however, studies reporting AGUS smears in pregnancy and postpartum period are very limited.Chhieng and colleagues 7 have reported the largest number of AGUS smears in pregnancy and postpartum period (n=35). Among the 13,361 smears performed during the 3-year study period, this group reported a 0.26% incidence rate with a mean patient age of 29. Of the 35 patients with AGUS smears, 8 patients were lost to follow up, 17 were referred for colposcopy and biopsy, and 10 had repeated smears. For those who underwent colposcopy and biopsy, five patients had histologically proven cervical intraepithelial lesions. The others had benign pathologies including squamous cell metaplasia, endocervical or endometrial polyps, Arias-Stella reactions and microglandular hyperplasia. Two of the 10 patients had persistent abnormalities on repeated smears but their outcomes were not reported. The authors reported the incidence of significant pathology in this study as 29%. However, the incidence rate of significant pathology was calculated on the basis of the 17 cases referred for colposcopy and biopsy only, and did not include the patients being followed with repeated smears which would reduce the rate of significant pathology to less than 20%.Two other studies have been reported on pregnancy related AGUS, although these involved smaller numbers of patients. Michael and colleagues 8 reported 26 cases of AGUS during pregnancy or postpartum period, most of which were followed with repeated cervical smears after 3 to 6 months. Biopsies were performed in the postpartum period only if atypia persisted on repeat smears. Eight patients had colposcopy directed biopsies and only 2 patients were diagnosed with squamous cell intraepithelial lesions. Kim and colleagues 9 reported a large study of 326 patients: 21 were diagnosed with AGUS during pregnancy or within 8 weeks postpartum. Only one of the 21 patients had significant pathology showing carcinoma in situ, though the method of follow-up was not specified. From the studies described above, the incidence of

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“…However, subclassification of AGC has yet to be proved clinically effective, and although The Bethesda Committee and many others have studied cytologic criteria important in subclassification, these criteria have not been tested vigorously. The rates of AGC (reported as AGUS before 2001) quoted in the literature vary from 0.095% to 1.83% (Nasu et al, 1993;Mood et al , 2006;Marques et al,2011;Tam et al,2003;Scheiden et al,2004;Pecorelli et al, 2009). Occasional mitosis may be seen.…”

Section: Definition Of Architectural Features -Glandular Crowdingmentioning

confidence: 99%

“…Deep cervical endometriosis is often associated with pelvic endometriosis and generally causes no problems in diagnosis. However, superficial endometriosis may be mistaken for CGIN (Tam et al, 2003). The presence of endometrial type stroma is a clue to the diagnosis but this is often significantly obscured by accompanying inflammation or hemorrhage and rarely by smooth muscle metaplasia.…”

Section: Tuboendometrioid Metaplasia and Endometriosismentioning

confidence: 99%

Cervical Glandular Intraepithelial Neoplasia (CGIN)

Izadi-Mood¹,

Sarmadi²,

Sotoudeh³

2012

Intraepithelial Neoplasia

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A retrospective review on atypical glandular cells of undetermined significance (agus) using the Bethesda 2001 classification

Cited by 57 publications

References 7 publications

Is Improved Detection of Adenocarcinoma in Situ by Screening a Key to Reducing the Incidence of Cervical Adenocarcinoma?

Is Improved Detection of Adenocarcinoma in Situ by Screening a Key to Reducing the Incidence of Cervical Adenocarcinoma?

Atypical Glandular Cells in Cervical Smear During Pregnancy and Postpartum Period

Cervical Glandular Intraepithelial Neoplasia (CGIN)

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