Glandular cell abnormalities in cervical cytology: What has changed in this decade and what has not?

Kumar, Neeta; Gupta, Sanjay

doi:10.1016/j.ejogrb.2019.06.006

Cited by 19 publications

(24 citation statements)

References 48 publications

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“…Adenocarcinomas, and squamous carcinoma accounted for 6.8%, and 4.1% of the cases with invasive cancers, respectively. In contrast to preinvasive lesions, the rate of cancer with glandular origin is higher in invasive cancers in accordance with the literature 23,24 . The majority of cancers detected in our study were in the age group of 50 years and older 22,2 .…”

Section: Discussionsupporting

confidence: 91%

“…In our study, 73 patients (0.8%) were diagnosed with AGC. This ratio is consistent with the rates between 0.05% and 6% indicated in the literature review study of Marques JP et al 7 in which 19 studies were examined in 2011 23 . In another literature study, the reported rate of AGC in cervical smears ranged from 0.08% to 2.5%.…”

Section: Discussionsupporting

confidence: 91%

“…Histological examination of AGC patients revealed premalignant and malignant lesions in 26 (35.6%) patients. In the literature, this rate varies in a very wide range as 17-100% [8][9][10][11][12][13][14][15][16][17][18][19][20]23,24 . In the study of Marques JP et al 20 the average detection rate of abnormal lesion was 58% 7 .…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of clinicopathologic features of patients diagnosed with atypical glandular cells on cervical cytology

Çakmak¹,

Kavak²,

Öge³

et al. 2019

MMJ

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Objective: In our study we aimed to evaluate the clinicopathologic features of patients diagnosed with atyipcal glandular cells on cervical cytology. Method: The records of 9375 patients who were examined in the gynecology outpatient clinic between 2010 and 2018 and underwent cervicovaginal smear were retrospectively reviewed. Seventy-three (0.8%) patients were diagnosed as atypical glandular cells. Colposcopic examination, cervical biopsy, endocervical and endometrial curettage were performed in patients diagnosed with atypical glandular cells. Age, gravida, parity, systemic diseases and clinicopathological features of the patients were examined and recorded Results: Cervical and endometrial abnormal histological findings were detected in 26 (35.6%) of 73 patients with atypical glandular cells. Of these 26 patients, 14 (19.1%) had cervical intraepithelial lesions, 3 (4.1%) had endometrial hyperplasia and 9 (12.3%) had invasive cancer. Five (6.8%) of the 9 patients with the diagnosis of invasive cancer had adenocarcinoma (endocervical and endometrial), in 3 (4.1%) patients cervical squamous carcinoma, and in 1 patient. endocervical lymphoma was observed.The majority of cancers detected in our study were in the age group of 50 years and older. Conclusion: Invasive cancer is seen in 12.3% of the patients diagnosed with atypical glandular cells, and most of these patients are 50 years or older. Therefore patients diagnosed with atypical glandular cell in cervicovaginal smear should be carefully evaluated with all clinical features.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

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Evaluation of clinicopathologic features of patients diagnosed with atypical glandular cells on cervical cytology

Çakmak¹,

Kavak²,

Öge³

et al. 2019

MMJ

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“…Glandular cells on cervical smears have garnered more attention in the last decade because of the increase in the incidence of cervical ADC, especially in young women. 39 Some reports showed higher rates of detection of glandular abnormalities in LBC smears, 40 because of better endocervical sampling with improved cell transfer in liquid medium and improved morphology. 40,41 However, other studies did not demonstrate such findings.…”

Section: Reported Thementioning

confidence: 99%

HPV Genotype Specific and Age Stratified Immediate Prevalence of Cervical Precancers and Cancers in Women with NILM/hrHPV+: A Single Center Retrospective Study of 26,228 Cases

Liu

Zhou

Zhang

et al. 2021

CMAR

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To investigate the prevalence of precancers [high-grade squamous intraepithelial lesion (HSIL) and adenocarcinoma in situ (AIS)] and cancers [squamous cell carcinoma (SCC) and adenocarcinoma (ADC)] in various high-risk human papillomavirus (hrHPV) genotypes or age groups among women with negative for intraepithelial lesion or malignancy (NILM) and hrHPV-positive pap results. Materials and Methods: In total, 26,228 women with NILM/hrHPV+ were included in the study. Among them, 5893 had immediate follow-up biopsy results available and were selected for further prevalence analysis. Results: About 7.6% and 0.7% women with NILM/hrHPV+ had HSIL and AIS, respectively. The prevalence of HSIL+ squamous lesions is significantly higher in HPV-16+ group than that in other genotype groups (p < 0.0001). The prevalence of AIS+ glandular lesions is significantly higher in HPV-18/45+ groups than women in other genotype groups (p < 0.0001). In addition, the prevalence of HSIL+ lesions was significantly higher in age 25-39 years group than that in age 40-65 years group and >65 years group (p < 0.0001). Overall, the prevalence of HSIL+ in younger women was significantly higher than that in older women when using a cutoff age of 40 years (9.3% vs 5.9%, p < 0.0001) or 50 years (8.6% vs 4.9%, p < 0.0001). No significant difference in AIS+ prevalence was found among different age groups (p = 0.611). Interestingly, the prevalence of SCC and ADC in older women (≥40 years, 0.3% and 0.3%, respectively) was significantly higher than that in younger women (<40 years, 0% and 0.07%) (p = 0.001 for SCC; p = 0.02 for ADC). Conclusion:The significant risk of cervical precancers and cancers still exists in women with NILM/hrHPV+, notably the older patient group had a lower risk of cervical precancer, but higher risk of cancer. Therefore, HPV genotyping can be an effective supplemental tool to cytology, and patient age also needs to be considered in the clinical management of patient.

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“…Then, in the current HPV vaccination era, the relative incidence of HPV-negative adenocarcinomas and their precursors may increase. Hypotheses of contributing factors to this increase in adenocarcinoma may be [46]:…”

Section: Adenocarcinoma Of the Cervix: Post Vaccination Incidence And Colposcopic Practicementioning

confidence: 99%

Are We Facing a New Colposcopic Practice in the HPV Vaccination Era? Opportunities, Challenges, and New Perspectives

et al. 2021

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The combination of primary and secondary prevention has already influenced the colposcopic practice by reduction in HPV (human papillomavirus) vaccine-type HSIL (HIGH-GRADE SIL), colposcopy referral numbers, colposcopic positive predictive value (PPV) for CIN2+, and by modification of referral pattern, colposcopic performance, and procedures. Different strategies, both isolated and combined, have been proposed in order to maintain the diagnostic accuracy of colposcopy: patient risk stratification based on immediate or future risk of CIN3+ or on HPV genotyping after a positive screening test. Data are needed to support alternative colposcopic strategies based on vaccination status and on the application of artificial intelligence where the patient’s risk stratification is implicit in precision medicine which involves the transition from an operator-dependent morphology-based to a less-operator dependent, more biomolecular management. The patient’s risk stratification based on any combination of “history” and “test results” to decrease colposcopy workload further reduce colposcopic and histologic morphological approaches, while adding genotyping to the risk stratification paradigm means less cytologic morphologic diagnosis. In Italy, there is a strong colposcopic tradition and there is currently no immediate need to reduce the number of colposcopies. Instead, there is a need for more accredited colposcopists to maintain the diagnostic accuracy of colposcopy in the vaccination era.

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Glandular cell abnormalities in cervical cytology: What has changed in this decade and what has not?

Cited by 19 publications

References 48 publications

Evaluation of clinicopathologic features of patients diagnosed with atypical glandular cells on cervical cytology

Evaluation of clinicopathologic features of patients diagnosed with atypical glandular cells on cervical cytology

HPV Genotype Specific and Age Stratified Immediate Prevalence of Cervical Precancers and Cancers in Women with NILM/hrHPV+: A Single Center Retrospective Study of 26,228 Cases

Are We Facing a New Colposcopic Practice in the HPV Vaccination Era? Opportunities, Challenges, and New Perspectives

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