Glandular Cell Abnormalities on SurePath Preparations: A Retrospective Review with Cytology-Histology Correlations

Abstract

Objective: Detecting glandular lesions is challenging by all Pap test methodologies. As the availability of data on identifying glandular abnormalities by SurePath is scarce, we investigated the detection rates and the correlation with histology follow-up. Study Design: A total of 105,927 cases (SurePath and conventional) were searched for the diagnosis of atypical glandular cells or higher glandular abnormalities (AGC+) with the corresponding histologic diagnosis. The associations between the Pap test methods and diagnostic categories were assessed by χ² test. Results: Overall, 0.32% of SurePath (159/49,375) and 0.29% of conventional (164/56,552) cases showed AGC+ (p = 0.38). Histology confirmed significant abnormalities in 42 versus 53.5% of the cases, respectively (p = 0.064); 72.7% (SurePath) versus 65.2% (conventional) of these were glandular in nature (p = 0.37). The diagnosis of neoplasia (favored or definitive) showed malignancy on follow-up in 100% of SurePath cases (12/12). In contrast, 82.1% of these conventional cases disclosed premalignant or malignant lesions by histology (p = 0.12). Conclusions: AGC+ cases showed higher prevalence on SurePath preparations. Conventional cases had more abnormalities on follow-up, while glandular lesions represented a higher proportion of abnormal histologies following SurePath AGC+s. The positive predictive value of favored or definite neoplasia was higher in SurePath cases. Overall, these differences were not statistically significant.

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

“…40,41 However, other studies did not demonstrate such findings. [42][43][44] These findings support a co-testing strategy, which may help with the detection of cervical carcinoma, especially for ADC and its precursor lesions.…”

Prevalence of cervical precancers or cancers in women with ASC-H/HSIL cytology according to Aptima HPV (AHPV) assay-detected HPV genotypes and age

“…Several studies have reported that LBC smears showed a high sensitivity for the detection of cervical ADC [27], possibly due to the morphologic characteristics of the samples [28]. Nevertheless, other studies have demonstrated that a co-testing strategy may be advantageous in the detection of cervical carcinoma, particularly ADC or its precursor lesions [29][30][31]. It is worth noting that among the 97 patients with ASC-H/HSIL cytology but negative hrHPV results in our study, 5 cases (5.2%) were diagnosed as CIN2+ squamous lesions, and 3 cases (3.1%) were diagnosed as AIS+ glandular lesions upon histological follow-up.…”

“…Remaining LBC samples were used for the AHPV assay (Hologic, Inc., San Diego, CA) following the manufacturer's instructions. The AHPV assay screened 14 hrHPV genotypes (16,18,31,33,35,39,45,51,52,56,58,59, 66, and 68) and further typed HPV 16 and 18/45.…”