Comparison Between Pap smear, Colposcopy and Cervical Histopathology Findings in Patients with Atypical Glandular Cells Results in Pap Smears

Objective: The presence of degenerative endometrial debris and abnormal endometrial cells is considered to be the hint for endometrial pathology. The purpose of this study was to evaluate the efficacy of Papanicolaou (Pap) smears in detecting endometrial cancers. Study Design: There were 146 cases of endometrial cancer diagnosed at our institute in 2000-2002 and 271 in 2010-2012. Among them, 57 and 95 relevant reports of Pap smears 6 months prior to the histology diagnosis were retrieved for this study, respectively. In the first time period, new criteria for detecting endometrial lesions had not yet been incorporated into routine screening. Results: Twenty cases (21%) of adenocarcinoma, 12 (13%) of atypical glandular cells, 4 (4%) of endometrial debris and 59 (62%) negative reports were found among the more recent 95 relevant Pap smears. The overall efficacy of the Pap smear for detecting endometrial malignancy was 38%, higher than 10 years previously (30%). Conclusion: Although the Pap smear was originally designed to screen cervical lesions, more effective detection of endometrial lesions could be achieved by adding new criteria to the routine screening.

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Atypical Findings on Cervicovaginal Smears Correlate with Cervical Involvement by Malignant Mixed Müllerian Tumors of the Uterus

Acta Cytologica ◽

10.1159/000439159 ◽

2015 ◽

Vol 59 (4) ◽

pp. 319-324 ◽

Cited By ~ 2

Author(s):

Krisztina Z. Hanley ◽

Gabriela Oprea-Ilies ◽

Claudia Ormenisan ◽

Shabnam Seydafkan ◽

Marina B. Mosunjac

Keyword(s):

Pap Smear ◽

Pap Test ◽

Pap Smears ◽

High Grade ◽

Histological Findings ◽

Pap Tests ◽

Glandular Cells ◽

Atypical Glandular Cells ◽

Abnormal Pap Tests ◽

Cervical Involvement

Objective: A malignant mixed müllerian tumor (MMMT) is a high-grade neoplasm commonly arising from the uterus. Patients present with bleeding and a mass protruding from the cervix. This study was designed to correlate Papanicolaou (Pap) smear findings with histological findings in women diagnosed with MMMT. Study Design: Women diagnosed with MMMT were identified. Preoperative Pap tests were correlated with histological findings. Statistical analysis was performed to assess associations between abnormal Pap tests and histological findings. Results: Forty patients with MMMT were included in the study. Age ranged from 37-85 years and tumor size ranged from 1.2 to 21 cm. In presurgical Pap tests (4 conventional and 36 liquid based), 11 smears (27.5%) were diagnosed as negative, 5 (12.5%) as atypical squamous cells of undetermined significance, 6 (15%) as atypical glandular cells, 16 (40%) as malignant and 2 (5%) as high-grade squamous intraepithelial lesion. Malignant cells detected on Pap smears showed a strong correlation with endocervical involvement by MMMT (p = 0.002). Larger tumors were more likely to involve the cervix (p = 0.0115). Conclusions: The Pap test can predict cervical involvement by MMMT. On Pap smears, MMMT cells showed no correlation with other adverse histological features (lymphovascular invasion, myoinvasion or adnexal involvement).

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More focus on atypical glandular cells in cervical screening: Risk of significant abnormalities and low histological follow-up rate

CytoJournal ◽

10.25259/cytojournal_77_2019 ◽

2020 ◽

Vol 17 ◽

pp. 22

Author(s):

Pingping Zhong ◽

Chenghong Yin ◽

Yulan Jin ◽

Tianbao Chen ◽

Yang Zhan ◽

...

Keyword(s):

Statistical Significance ◽

Cervical Screening ◽

Close Relation ◽

Prior History ◽

Pap Smears ◽

Chi Square ◽

Glandular Cells ◽

Atypical Glandular Cells ◽

Chi Square Test

Objectives: Atypical glandular cells (AGC) detected by Papanicolaou (Pap) smears are in close relation with adenocarcinoma and precursors detected by histopathology. Yet, sometimes the cytological diagnosis of AGC has been neglected. With increase of adenocarcinoma and precursors, we need more focus on glandular abnormalities. Material and Methods: Clinicopathological data of patients who had AGC on Pap smears between April 2015 and October 2018 and underwent histological follow-up were retrieved from the computerized database of Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Patients with a prior history of cancer were excluded from the study. Statistical analyses were performed using Pearson’s Chi-square test in SPSS software version 23. P < 0.05 (two sided) was considered as statistical significance. Results: Liquid-based cytological examination of the uterine cervix was carried out in 164,080 women. Five hundred and twenty-five women were diagnosed with AGC, 314 with not otherwise specified (AGC-NOS), and 211 with favor neoplastic (AGC-FN). Only 310 cases had histological follow-up, 168 women (168/314, 53.5%) originally with AGC-NOS on Pap smears, and 142 (142/211, 67.3%) with AGC-FN. The median age of histological significant abnormalities was 46.7 years, and 126 women (126/162, 77.8%) were postmenopausal. Sixty-six cases (66/168, 39.3%) of AGC-NOS had significant abnormalities (96/142, 67.6%, AGC-FN). One hundred and sixty-two cases of significant abnormalities included 40 high-grade squamous abnormalities and 122 glandular abnormalities. AGC-FN was more likely to be associated with a clinically significant abnormalities (P < 0.001) compared to AGC-NOS. Conclusions: Patients with AGC on Pap smears are in close relation with significant abnormalities, especially with significant glandular abnormalities on histopathology slices. AGC should be evaluated vigilantly with histological workup, especially if patients are diagnosed with AGC-FN and are aged 41–60 years. We need more focus on AGC.

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