Clinical evaluation of atypical glandular cells of undetermined significance

• Published in: American journal of obstetrics and gynecology 2001-01, Vol.184 (2), p.64-69
• Main Authors: Geier, Christian S., Wilson, Mary, Creasman, William
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - pathology; Adult; Atypical glandular cells of undetermined significance; Bethesda System; Biological and medical sciences; Biopsy; cervical intraepithelial neoplasia; Cervical Intraepithelial Neoplasia - pathology; Cervix Uteri - pathology; Colposcopy; Endometrial Neoplasms - pathology; Female; Genital system. Mammary gland; Humans; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Middle Aged; Papanicolaou Test; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Retrospective Studies; Uterine Cervical Neoplasms - pathology; Vaginal Smears
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1067/mob.[phone]

Objective: This study was undertaken to determine the clinical implications of the finding of atypical glandular cells of undetermined significance in cervical cytologic specimens in our patient population. Study Design: A retrospective study was performed. All cervical cytologic examinations with the diagnosis of atypical cells of undetermined significance between January 1992 and June 1997 were identified by means of a computerized database. Medical records were reviewed to identify patient demographic characteristics and to determine the presence or absence of associated pathologic conditions of the cervix and endometrium. The χ2 test and analysis of variance were applied to dichotomous and continuous variables, respectively, to determine the implications of a cytologic evaluation of atypical glandular cells of undetermined significance. Results: Cytologic results reported as atypical glandular cells of undetermined significance were obtained in a patient cohort of 492. Atypical glandular cells of undetermined significance was the only cytologic diagnosis in 224 patients; 268 patients had both atypical glandular cells of undetermined significance and an additional squamous abnormality, including atypical squamous cells of undetermined significance and cervical intraepithelial neoplasia I, II, or III. Two patients were excluded because of a history of endometrial cancer. A histologic evaluation was obtained within 1 year in 353 cases. Among the 353 patients who had a histologic evaluation performed, 227 (64%) had benign cervical and endometrial findings. There were 18 glandular lesions (5%), including complex hyperplasia with atypia, adenocarcinoma in situ of the cervix, adenocarcinoma of the cervix, and adenocarcinoma of the endometrium. A squamous lesion was present in 108 patients (31%). Most squamous lesions (81%) were found in patients with atypical glandular cells of undetermined significance associated with a squamous abnormality, whereas only 19% were found in patients with atypical glandular cells of undetermined significance as the only diagnosis. Women 50 years old (P 50 years old had a much higher frequency of glandular histologic abnormalities (P