Adenocarcinoma cells in Pap smears

Mulvany, Nicholas J.; Mitchell, Gerardine; Allen, David G.

doi:10.1080/00313020903042604

Cited by 12 publications

(12 citation statements)

References 81 publications

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“…Potential reasons for false negative results include: more blood cells on the slide, a poor representation of abnormal cells on cytology being hidden in the background of normal squamous cells, a minimal cell disruption difficult to read, and finally the number of abnormal cells on the slide could be so high that reader may fail to recognize the lesion [29]. However, a higher proportion of true negative results could also be expected when glandular lesions do not involve the transformation zone and thus are not represented in the smear because the lesion is located in the endocervical canal.…”

Section: Discussionmentioning

confidence: 99%

Poor Cervical Cancer Screening Attendance and False Negatives. A Call for Organized Screening

et al. 2016

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ObjectiveThe objective of this study was to describe prior negative screening history and symptoms around the time of diagnosis of incident cervical cancer (CC) cases diagnosed between 2000 and 2010 within the Asturias public health system.MethodsRecords from 374 women diagnosed with CC between 2000 and 2010 from all public hospitals in Asturias were retrieved. Clinical information, FIGO stage and all previous cytological data were extracted from clinical and histopathological records. Proportional differences were assessed using chi-square tests. Logistic regression analysis was used to estimate odds ratios (OR) and 95% confidence intervals (CI). Inter-observer agreement in cytology was checked by comparing concordance values using k-statistics.ResultsNo prior screening history was recorded in 60.7% of CC cases and its absence increased with age and advanced stage. Advanced stage (e.g., ≥ II) at diagnosis was associated with age (>50 years) and adenocarcinoma (ADC) compared to younger women and those with a squamous cell carcinoma (SCC). False negative smears were identified in 27.1% of women with CC (ADC 52.6% vs. SCC 16.2%, p<0.05).ConclusionsAbsence of prior screening history was common among CC cases. Organized actions to reduce “under screening” and the use of highly sensitive HPV-based tests could be useful strategies in reducing the burden of CC in Asturias.

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Section: Discussionmentioning

confidence: 99%

Poor Cervical Cancer Screening Attendance and False Negatives. A Call for Organized Screening

et al. 2016

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“…It did not overcome, however, the paradox of lower HPV positivity in ADC (84.6%) than in AIS (99.1%) and SCC (92.0%). Some misclassification of extrauterine adenocarcinoma as ADC 9 and the existence of some rare varieties of ADC that are not related to HPV infection 10 cannot be ruled out.…”

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confidence: 99%

Human papillomavirus types in glandular lesions of the cervix: A meta‐analysis of published studies

Guan

Clifford

Franceschi

2012

Intl Journal of Cancer

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Dear Editor, Glandular preinvasive lesions of the cervix (i.e., atypical glandular cells, AGC and adenocarcinoma in situ, AIS) are more likely to be missed in cytological cervical screening than their squamous-cell equivalents, owing to their location in the endocervical canal and difficulties in their cytological and colposcopical assessment. 1,2 Hence, in well-screened populations, although the incidence of cervical cancer has been decreasing over the last three decades, the ratio of adeno/adenosquamous (ADC) to squamous cell carcinoma (SCC) has been rising. 1,3 Screening using high-risk (HR) HPV rather than cytology can improve prevention of ADC. 4 Human papillomavirus (HPV) 18 is more frequently detected in ADC than in SCC and this tendency may also apply to other types (e.g., HPV45) that belong to the same alpha-7 species as HPV18. 5 However, in contrast to the extensive information about HPV types across the complete spectrum of squamous cervical lesions, 6 little is known about the pattern of HPV types in glandular preinvasive lesions, and how it compares to that in ADC.With the aim to improve our understanding of the carcinogenic process for individual HR types from infection of glandular tissue to adenocarcinoma, we performed a systematic literature review of HPV type-specific prevalence data in preinvasive glandular neoplastic lesions, and compared to similar data on women with normal cytology and ADC reported in a recently published meta-analysis. 6 Methods have been reported previously. 6 In brief, Medline was used to search for publications from January 1990 to November 2011 using combinations of the MeSH terms: ''cervical cancer,'' ''cervical intraepithelial neoplasia,'' ''HPV,'' ''human,'' ''female'' and ''polymerase chain reaction.'' Eligible studies met the following criteria: (i) use of broad-spectrum consensus PCR-assays based on the primers MY09/11, PGMY09/11, GP5þ/6þ, SPF10, SPF1/GP6 or L1C1/L1C2, and (ii) reporting of overall and type-specific HPV prevalence, by strata of cyto-and/or histo-pathological cervical diagnoses.Overall HPV prevalence is reported as a percentage of all women tested by consensus PCR. Type-specific HPV positivity is presented among HPV-positive women only, for each of the 13 HR HPV types judged to be carcinogenic or probably carcinogenic (i.e., HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 68), 1 in the order of their frequency of detection in ADC. 7 Type-specific positivity includes that contributed by single and multiple HPV infections. Standard errors of type-specific positivity estimates were computed assuming the nonindependence of cases within the same study using cluster-correlated robust variance estimates. 8 We identified 12 studies reporting relevant data on AGC and/or AIS from Europe (n ¼ 4, Belgium, Italy and two studies from The Netherlands), North America (n ¼ 5, all from the United States), Eastern Asia (n ¼ 1, Thailand), Western Asia (n ¼ 1, Kuwait) and South/Central America (n ¼ 1, Brazil). As data on both AGC and AIS were available only for...

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“…The presence of luminal neoplastic cells may be relevant, as it is recognized increasingly that the Fallopian tubes are likely to play an important role in tumour dissemination, either from the peritoneal cavity towards the lower genital tract, such as the cases presented herein, or conversely from the cervix and endometrium towards the tubes and intra‐abdominal sites 20–22 . Rarely, malignant cells of non‐gynaecological origin are detected in routine cervical smears, leading in some cases to the detection of occult abdominal malignancies 8,9,23,24 . Because this may occur without direct tumour involvement of the cervical or endometrial mucosa, it is likely that the cells are derived from the peritoneal cavity via transtubal spread.…”

Section: Discussionmentioning

confidence: 87%

“…The Fallopian tubes can also act as a conduit transporting malignant cells from the peritoneal cavity towards the lower genital tract, in some cases leading to implant‐type metastases on the mucosal surfaces of the endometrium or the cervix. Tubal transportation of malignant cells explains the occasional abnormal cervical cytology findings in patients with known or occult intra‐abdominal malignancies 8,9 …”

Section: Introductionmentioning

confidence: 99%

Fallopian tube metastases of non‐gynaecological origin: a series of 20 cases emphasizing patterns of involvement including intra‐epithelial spread

2012

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The Fallopian tubes are commonly involved in patients who have neoplasms metastatic to the ovaries. Metastases may show a CIS-like pattern of intra-epithelial spread and therefore small serous CIS-type lesions may not represent proof of tubal tumour origin in patients who have high-stage pelvic serous carcinomas. The frequency of intra-lumenal tumour cells supports transtubal spread as a likely mechanism for mucosal involvement by metastatic tumours involving the lower genital tract.

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Adenocarcinoma cells in Pap smears

Cited by 12 publications

References 81 publications

Poor Cervical Cancer Screening Attendance and False Negatives. A Call for Organized Screening

Poor Cervical Cancer Screening Attendance and False Negatives. A Call for Organized Screening

Human papillomavirus types in glandular lesions of the cervix: A meta‐analysis of published studies

Fallopian tube metastases of non‐gynaecological origin: a series of 20 cases emphasizing patterns of involvement including intra‐epithelial spread

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