LBC versus Conventional Pap Smear in AGUS; Do we do any better with Liquid-Based Preparations?

Abstract

A diagnosis of AGUS is given when glandular cells of endocervical or endometrial origin (if > 45 of age) display nuclear atypia that exceeds obvious reactive changes but lack unequivocal features of adenocarcinoma in situ (ACIS) or invasive adenocarcinoma. The percentage of this diagnostic category varies considerably. The mean percentage of AGUS diagnoses in cervical cytology in Norway is 0.18% with a range of 0.06-0.48%. At Akershus University hospital (Ahus) 0.09% of cervical cytology diagnoses were AGUS in 2016. Our department changed from conventional to liquidbased slides during 2013-2014. The aim of our study was to see if the introduction of LBC had had any impact on the diagnosis of AGUS. We compared two cohorts of cervical smears: a three years cohort (2011-2013) of conventional Pap smears and a three years cohort (2014-2016) of Sure Path LBC smears. There were 82 women in the conventional Pap smear cohort (0.08%) and 95 in the Sure Path LBC cohort (0.09%) and all had histologic follow-up. There was no statistically difference in the results of the two cohorts. In conclusion, our major challenge in the diagnosis of AGUS are the cytological criteria and not our preparation method.