Factors affecting the histopathological outcomes of atypical glandular cells on pap test

Introduction: Endometrial cancer is the second most common gynecological tumor. There is still no recommended screening method for endometrial cancer. The application of transvaginal sonography, hysteroscopy and Pap test may prove useful in screening for this disease. Atypical glandular cells represent an important finding in Pap tests and they are related to histopathological verification of the endometrium. The aim of the study was to determine the usefulness of the Pap test in assessing the cervical infiltration, as well as to determine the significance of hormonal status and histopathological type of tumor in a pathological Pap test in patients with endometrial cancer.Methods: The study was retrospective. The analysis included the data obtained from 62 operated patients diagnosed with enometrial cancer, medical history (menopausal status), histopathological findings after surgery (type and stage of the disease) and a preoperative Pap smear. The chi squared and Fisher’s test were used.Results: The difference in the prevalence of pathological Pap test in premenopausal and postmenopausal group of patients was not statistically significant. The difference in the prevalence of pathological Pap test in the group of endometrioid and non-endometrioid tumours of the uterine corpus had statistical significance. The difference in the prevalence of pathological Pap test compared to the present stage (I and II) was not statistically significant.Conclusion: Pap smear does not correlate with menopausal status in women with endometrial carcinoma. Abnormal Pap test is more commonly found in cases of non-endometroid tumours. Pap smears cannot beused to assess cervical involvement.

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The Effect of Continuous Monitoring of Cytologic-Histologic Correlation Data on Cervical Cancer Screening Performance

Archives of Pathology & Laboratory Medicine ◽

10.5858/2008-132-16-teocmo ◽

2008 ◽

Vol 132 (1) ◽

pp. 16-22 ◽

Cited By ~ 2

Author(s):

Stephen S. Raab ◽

Bruce A. Jones ◽

Rhona Souers ◽

Joseph A. Tworek

Keyword(s):

Predictive Value ◽

Continuous Monitoring ◽

False Negative ◽

Pap Test ◽

Mixed Linear Model ◽

Squamous Cells ◽

Test Sensitivity ◽

Correlation Data ◽

Glandular Cells ◽

Atypical Glandular Cells

Abstract Context.—The use of Papanicolaou (Pap) test cytologic-histologic correlation in quality improvement activities is not well studied. Objective.—To determine if continuous monitoring of correlation data improves performance. Design.—Participants in the College of American Pathologists Q-Tracks program (213 laboratories) self-reported the number of Pap test–histologic biopsy correlation discrepancies every quarter for up to 8 years. A mixed linear model determined if the length of participation in the Q-Tracks program was associated with improved performance. Main outcome measures were predictive value of a positive Pap test, Pap test sensitivity, sampling sensitivity, and proportion of positive histologic diagnoses following a Pap test diagnosis of atypical squamous cells or atypical glandular cells. Results.—Institutions evaluated 287 570 paired Pap test– histologic correlation specimens and found 98 424 (34.2%) true-positive Pap test correlations, 19 006 (6.6%) false-positive Pap test correlations, and 6575 (2.3%) false-negative Pap test correlations. The mean predictive value of a positive Pap test, sensitivity, screening and interpretive sensitivity, sampling sensitivity, and proportion of positive histologic diagnoses following a Pap test diagnosis of atypical squamous or glandular cells were 83.6%, 93.7%, 99.2%, 94.2%, 60.3%, and 38.8%, respectively. Longer participation was significantly associated with a higher predictive value of a positive Pap test (P = .01), higher Pap test sensitivity (P = .002), higher Pap test sampling sensitivity (P = .03), and higher proportion of positive histologic diagnoses for a Pap test diagnosis of atypical squamous cells (P < .001). Conclusions.—Long-term monitoring of cytologic-histologic correlation is associated with improvement in cytologic-histologic correlation performance.

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Atypical endometrial cells and atypical glandular cells favor endometrial origin in Papanicolaou cervicovaginal tests: Correlation with histologic follow-up and abnormal clinical presentations

CytoJournal ◽

10.4103/1742-6413.144686 ◽

2014 ◽

Vol 11 ◽

pp. 29 ◽

Cited By ~ 2

Author(s):

Longwen Chen ◽

Christine N. Booth ◽

Julie A. Shorie ◽

Jennifer A. Brainard ◽

Matthew A. Zarka

Keyword(s):

Vaginal Bleeding ◽

Pap Test ◽

Pap Tests ◽

Endometrial Cells ◽

Clinical Presentations ◽

Glandular Cells ◽

Atypical Glandular Cells ◽

Abnormal Vaginal Bleeding ◽

Endometrial Pathology

The 2001 Bethesda system recommends further classifying atypical glandular cells (AGCs) as either endocervical or endometrial origin. Numerous studies have investigated the clinical significance of AGC. In this study, we investigated the incidence of clinically significant lesions among women with liquid-based Papanicolaou cervicovaginal (Pap) interpretations of atypical endometrial cells (AEMs) or AGC favor endometrial origin (AGC-EM). More importantly, we correlated patients of AEM or AGC-EM with their clinical presentations to determine if AEM/AGC-EM combined with abnormal vaginal bleeding is associated with a higher incidence of significant endometrial pathology. All liquid-based Pap tests with an interpretation of AEM and AGC-EM from July, 2004 through June, 2009 were retrieved from the database. Women with an interpretation of atypical endocervical cells, AGC, favor endocervical origin or AGC, favor neoplastic were not included in the study. The most severe subsequent histologic diagnoses were recorded for each patient. During this 5-year period, we accessioned 332,470 Pap tests of which 169 (0.05%) were interpreted as either AEM or AGC-EM. Of the 169 patients, 133 had histologic follow-up within the health care system. The patients ranged in age from 21 to 71 years old (mean 49.7). On follow-up histology, 27 (20.3%) had neoplastic/preneoplastic uterine lesions. Among them, 20 patients were diagnosed with adenocarcinoma (18 endometrial, 1 endocervical, and 1 metastatic colorectal), 3 with atypical endometrial hyperplasia, and 4 with endometrial hyperplasia without atypia. All patients with significant endometrial pathology, except one, were over 40 years old, and 22 of 25 patients reported abnormal vaginal bleeding at the time of endometrial biopsy or curettage. This study represents a large series of women with liquid-based Pap test interpretations of AEM and AGC-EM with clinical follow-up. Significant preneoplastic or neoplastic endometrial lesions were identified in 20.3% of patients. Patients with Pap test interpretations of AEM or AGC-EM and the clinical presentation of abnormal vaginal bleeding should be followed closely.

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Medical diligence uncovers fallopian tube cancer after abnormal Pap test

BMJ Case Reports ◽

10.1136/bcr-2019-229762 ◽

2019 ◽

Vol 12 (7) ◽

pp. e229762

Author(s):

Cara Buskmiller ◽

Brittany Cline ◽

Francisco Xynos

Keyword(s):

Fallopian Tube ◽

Transvaginal Ultrasound ◽

Pap Test ◽

Serous Carcinoma ◽

Ca 125 ◽

Fallopian Tube Cancer ◽

Pelvic Malignancies ◽

Dilation And Curettage ◽

Glandular Cells ◽

Atypical Glandular Cells

The fallopian tube has received attention as an origin of high-grade pelvic malignancies. This is a case of bilateral fallopian tube cancer discovered after an abnormal Pap test. A 62-year-old woman with a history of one term delivery had atypical glandular cells on a Pap test. She had an unsatisfactory colposcopy and a normal transvaginal ultrasound. A loop electrode excision procedure and hysteroscopy with dilation and curettage revealed atypical glandular cells concentrated in floating balls. CA-125 was 10 U/mL. A robotic hysterectomy revealed histopathological stage IIIA serous carcinoma arising from both fallopian tubes. She received six cycles of carboplatin and paclitaxel. After chemotherapy, she has no evidence of disease at 5 years. Fallopian tube carcinoma is a differential diagnosis of abnormal glandular cells on a Pap test. Diagnosis by systematic pursuit of abnormal tests can lead to successful treatment of a small disease burden.

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Pathologic findings in women with atypical glandular cells on Pap test

Journal of the American Society of Cytopathology ◽

10.1016/j.jasc.2015.09.213 ◽

2016 ◽

Vol 5 (1) ◽

pp. 50-55 ◽

Cited By ~ 1

Author(s):

Sagar Dhamne ◽

Esther Soundars ◽

Neda Zarrin-Khameh

Keyword(s):

Pap Test ◽

Pathologic Findings ◽

Glandular Cells ◽

Atypical Glandular Cells

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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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Histologic follow-up results in 662 patients with Pap test findings of atypical glandular cells: Results from a large academic womens hospital laboratory employing sensitive screening methods

Gynecologic Oncology ◽

10.1016/j.ygyno.2009.05.019 ◽

2009 ◽

Vol 114 (3) ◽

pp. 383-389 ◽

Cited By ~ 94

Author(s):

Chengquan Zhao ◽

Anca Florea ◽

Agnieszka Onisko ◽

R. Marshall Austin

Keyword(s):

Pap Test ◽

Screening Methods ◽

Hospital Laboratory ◽

Glandular Cells ◽

Atypical Glandular Cells

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

Acta Cytologica ◽

10.1159/000493000 ◽

2018 ◽

Vol 62 (5-6) ◽

pp. 423-429 ◽

Cited By ~ 2

Author(s):

Gabor Fischer ◽

Karen Cormier

Keyword(s):

Pap Test ◽

Test Methods ◽

Glandular Cell ◽

Histologic Diagnosis ◽

Detection Rates ◽

Diagnostic Categories ◽

Glandular Cells ◽

Atypical Glandular Cells ◽

Malignant Lesions

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.

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