Management of patients with atypical glandular cell cytology at our hospital

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  • SASA Hidenori
    Department of Obstetrics and Gynecology, National Defense Medical College
  • MATSUURA Hiroko
    Department of Obstetrics and Gynecology, National Defense Medical College
  • TAKASAKI Kazuki
    Department of Obstetrics and Gynecology, National Defense Medical College
  • NAKAYAMA Misaki
    Department of Laboratory Medicine, National Defense Medical College Hospital
  • SHIMAZAKI Hideyuki
    Department of Laboratory Medicine, National Defense Medical College Hospital
  • TAKANO Masashi
    Department of Obstetrics and Gynecology, National Defense Medical College

Bibliographic Information

Other Title
  • 異型腺細胞 (AGC) の取り扱い
  • ―2nd report―
  • ―高度病変の潜在性 (第 2 報)―

Description

<p>Objective : It is difficult to manage patients with atypical glandular cell (AGC) cytology, as the diagnostic criteria for suspected adenocarcinoma in situ (AIS) or invasive adenocarcinoma in the presence of AGC may be unclear. We report the management of patients with AGC cytology at our hospital.</p><p>Methods : Data of a total 66 patients (mean age : 44.2 years old) referred for AGC cytology over the past 11 years were retrospectively analyzed. The results of cytology and biopsy performed under colposcopic guidance were compared with the clinical course and histological diagnosis in the patients with AGC cytology.</p><p>Results : The results of repeat cytology in the 66 patients revealed AGC in 27 cases, AIS in 3 cases, high-grade squamous intraepithelial lesion (HSIL) in 8 cases, and AGC+HSIL in the Bethesda system in 11 cases. The biopsies performed under colposcopic guidance revealed a total of 30 cases (45%) with high lesions (i.e. cervical intraepithelial lesion 2+ or AIS), which was significantly lower than the number yielded by cytology. Conization was performed in 40 patients, and histopathologic examination revealed high lesions in 36 of the 40 patients. Seven patients (17.5%) had squamous and glandular lesions. Seven patients showed positive cytology, negative biopsy and positive conization histology. Human papillomavirus (HPV) genotype was examined in 27 patients and 13 were found to be positive for high-risk genotypes.</p><p>Conclusion : Since more than half of the patients with AGC cytology showed latent malignant lesions, diagnostic conization could be considered, especially in cases positive for high-risk HPV genotypes.</p>

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