Endocervical Glandular Atypia and Adenocarcinoma

Nasu, Ichiro; Meurer, William T.; Fu, Yao

doi:10.1097/00004347-199307000-00002

Cited by 71 publications

(80 citation statements)

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“…The PPVs for the endocervical AGUS subcategories demonstrated a marked difference between the "favor neoplasia" designation and either the "unspecified" or "favor reactive" designations in both types of preparations (67% vs. 28% vs. 10% in TPs and 77% vs. 23% vs.4% in CPs). These differences are similar to those reported in other studies of biopsy follow-up results after an AGUS interpretation in CPs, [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] and in one similar study using TPs, 20 and demonstrate that differences in PPVs among endocervical AGUS subcategories are similar in both TPs and CPs. Although the number of cases was small, we found that the AGUS "endometrial" category had a very low PPV in both groups.…”

Section: Discussionsupporting

confidence: 89%

“…[2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] In general, those laboratories that report lower AGUS frequencies have higher PPVs for the detection of a high-grade precursor lesion or carcinoma and for lesions found to have glandular rather than squamous differentiation on follow-up. 6,9,16 In contrast, laboratories with higher AGUS frequencies have shown a high preponderance of either benign processes or high-grade CIN on biopsy follow-up. 3,11,14 In the current study, a similar trend was noted within a single laboratory when the frequency and follow-up of AGUS were compared for the two methods of slide preparation.…”

Section: Discussionmentioning

confidence: 99%

“…AGUS has been a problematic interpretation clinically because biopsy follow-up mostly has shown either a benign reactive process or a squamous precursor lesion (cervical intraepithelial neoplasia [CIN]) rather than a glandular one. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] The ThinPrep Papanicolaou test (TP) (Cytyc Corporation, Boxborough, MA) is a slide preparation method that utilizes liquid fixa-tion of the exfoliated cells. It has been shown to produce well preserved thin-layer slides devoid of the artifacts that may contribute to inaccuracies in the interpretation of conventional smears.…”

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confidence: 99%

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Atypical glandular cells of undetermined significance in conventional cervical/vaginal smears and thin-layer preparations

Sheets¹,

Lee²

2002

Cancer

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Atypical glandular cells of undetermined significance in conventional cervical/vaginal smears and thin-layer preparations

Sheets¹,

Lee²

2002

Cancer

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“…Most laboratories report an AGUS rate Ͻ 1%. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] The AGUS rate of 0.56% observed among the general patient population in our laboratory was in agreement with the current literature. Few studies have investigated the incidence of atypical endometrial cells in cervicovaginal smears.…”

Section: Discussionsupporting

confidence: 88%

“…[3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Little is known about the clinical significance of AGUS, favor endometrial origin (AGUS-EM). In this retrospective study, we determined the rate of a diagnosis of AGUS-EM and the incidence of clinically significant lesions in women with this cytologic diagnosis on subsequent follow-up.…”

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confidence: 99%

Clinical implications of atypical glandular cells of undetermined significance, favor endometrial origin

Chhieng

Elgert

Cohen

et al. 2001

Cancer

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Expression of MN/CA9 protein in Papanicolaou smears containing atypical glandular cells of undetermined significance is a diagnostic biomarker of cervical dysplasia and neoplasia

Liao

Stanbridge

2000

Cancer

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BACKGROUND Despite the enormous impact that Papanicolaou (Pap) smear screening has had on the incidence of cervical carcinoma in developed countries, there is still an unacceptably high frequency of occurrence of this cancer. In part, this is due to human error associated with cytologic diagnoses of Pap smears. Also, the use of new sampling devices, such as the cytobrush, has increased the complexity of diagnosing benign and neoplastic cervical cytology. This is particularly apparent in the diagnosis of atypical glandular cells of undetermined significance (AGUS). Approximately 40% of AGUS diagnoses have a corresponding significant lesion at biopsy follow‐up, and 60% do not. There is clearly a need for an adjunct to cytologic diagnosis that can readily identify AGUS smears that are diagnostic of significant lesions. The authors have identified the MN/CA9 antigen as a strong candidate for an adjunct biomarker. METHODS A total of 245 Pap smears of all AGUS diagnostic categories with histologic confirmation were studied. The median age of the patients was 39 years. The Bethesda system classification (AGUS–favor reactive, AGUS–not otherwise specified, and AGUS–favor neoplastic) was used. All of the Pap smears were decolorized and immunostained with monoclonal antibody to MN/CA9 antigen by the immunoperoxidase technique. The results of MN/CA9 immunoreactivity were correlated with the histologic data in a semiblinded fashion. RESULTS The follow‐up biopsies showed that a high percentage (70%) of patients had low and high grade cervical intraepithelial neoplasia lesions, respectively (CIN I and CIN II or III). Clinically significant lesions—adenocarcinoma in situ/carcinoma (AIS/CA) and CIN II or III—were found in 50% of the cases. Among these, 11% were AIS/CA. In the three subcategories of AGUS diagnosis, the AGUS–not otherwise specified showed the broadest range of lesions in the follow‐up biopsies. Three patterns of MN/CA9 immunoreactivity were observed in the Pap smears: 1) atypical cells, 2) normal endocervical cells only, and 3) all cells negative. All Pap smears that were MN/CA9 positive were histologically confirmed to be clinically significant lesions or CIN I; in addition, there were a very small number (n = 12) of cases of atypia. None of the benign lesions showed MN/CA9 expression in the corresponding Pap smears. Furthermore, the pattern of atypical cell immunostaining identified all cases with significant lesions (AIS/CA and CIN II or III) in the cervices. Conversely, the majority of CIN I cases (82%) and all cases of atypia showed positive immunostaining restricted to normal endocervical cells only. CONCLUSIONS There is a clear association between MN/CA9 immunostaining of atypical cells and the presence of significant lesions in the cervix. Similarly, there is a clear association between lack of expression of MN/CA9 and the absence of cervical lesions. However, the screen does not allow discrimination between CIN I and atypia. The authors also found that, based on the combined patterns of morphology...

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Endocervical Glandular Atypia and Adenocarcinoma

Cited by 71 publications

References 0 publications

Atypical glandular cells of undetermined significance in conventional cervical/vaginal smears and thin-layer preparations

Atypical glandular cells of undetermined significance in conventional cervical/vaginal smears and thin-layer preparations

Clinical implications of atypical glandular cells of undetermined significance, favor endometrial origin

Expression of MN/CA9 protein in Papanicolaou smears containing atypical glandular cells of undetermined significance is a diagnostic biomarker of cervical dysplasia and neoplasia

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