Atypical glandular cells of undetermined significance in conventional cervical/vaginal smears and thin-layer preparations

Sheets, Ellen E.; Lee, Kenneth R.

doi:10.1002/cncr.10312.abs

Cited by 4 publications

(7 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The following prevalences of pathology were calculated: 5.2% malignancy, 2.9% adenocarcinoma in situ, and 1.4% endometrial hyperplasia. All calculations involving LSIL and HSIL in this review were based on the exclusion of additional studies that classified LSIL/HSIL as a "normal" or "benign" finding on Pap test 15,16 (Table 1). High-grade squamous intraepithelial lesion had a prevalence of 11.1%, and LSIL had a prevalence of 8.5%.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Significance of Atypical Glandular Cells on Cervical Cytology

Schnatz

Guile

O’Sullivan

et al. 2006

Obstetrics & Gynecology

148

118

View full text Add to dashboard Cite

Histologic diagnosis showed that 29.0% of these Pap tests had findings requiring follow-up or therapeutic intervention, including a 5.2% rate of malignancy. Based on these findings, 99.6% of the diagnoses are within the region of surveillance when AGUS Pap tests are evaluated with colposcopy and directed biopsy, endocervical curettage, an endometrial biopsy in patients with risk factors for endometrial cancer, and pelvic examination.

show abstract

Section: Resultsmentioning

confidence: 99%

“…2), a statistically significant difference was detected for LSIL and HSIL (P Ͻ .001). Twelve studies 3,5,[11][12][13][15][16][17][18]21,23,24 determined the histologic diagnosis of 1,253 AGUS tests that had been further subclassified as favor reactive, favor neoplastic, or not otherwise specified (Figs. 3A and 3B).…”

Section: Resultsmentioning

confidence: 99%

Clinical Significance of Atypical Glandular Cells on Cervical Cytology

Schnatz

Guile

O’Sullivan

et al. 2006

Obstetrics & Gynecology

148

118

View full text Add to dashboard Cite

show abstract

“…In published studies, AGC rates are extremely variable, ranging from 0.1% to more than 1% of all smears, but most commonly are in the 0.4% to 0.5% range. 11 Follow-up data indicate that higher AGC rates are largely due to misdiagnoses of high-grade squamous precursor lesions and/or benign glandular atypias. The association with clinically significant pathology decreases with increasing AGC rates.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8] However, AGC also may be associated with high-grade squamous precursor lesions and glandular neoplasia, including not only cervical adenocarcinoma and its precursor lesion endocervical adenocarcinoma in situ (ACIS) but also remote neoplasms such as endometrial and extrauterine adenocarcinomas. [9][10][11][12] Thus, despite its association with benign conditions, a cytologic interpretation of AGC is associated with a high risk of neoplasia.…”

mentioning

confidence: 99%

Atypical Glandular Cells of Undetermined Significance: Outcome Predictions Based on Human Papillomavirus Testing

Krane

Lee

Sun

et al. 2004

American Journal of Clinical Pathology

Self Cite

View full text Add to dashboard Cite

Cases of atypical glandular cells (AGC) diagnosed on liquid-based preparations were culled from a 3-year period. When available, residual cellular material was analyzed for human papillomavirus (HPV) by polymerase chain reaction and correlated with cytologic and histologic (biopsy) outcome. Of 178,994 cytologic cases, 187 (0.1045%) contained AGC compared with 8,740 (4.8828%) atypical squamous cells (ASC) for an AGC/ASC ratio of 0.021. HPV results and follow-up were available for 108 specimens from 106 patients. Depending on the end-point (histologic/cyto-logic), the sensitivity range of HPV testing for significant cervical disease (high-grade squamous intraepithelial lesion [SIL], adenocarcinoma in situ [ACIS], invasive carcinoma) was 83% with a specificity range of 78% to 82%, a positive predictive value of 57% to 61%, and a negative predictive value of 91% to 95%. Fifteen false-positive results included concurrent ASC or low-grade SIL, ASC on follow-up cytology, and previous ACIS with a negative follow-up cone biopsy result. Noncervical glandular neoplasia (including atypical endometrial hyperplasia) was confirmed in 13 cases (1 recurrent), only 2 of which scored positive for HPV. HPV-positive AGC has a substantially higher positive predictive value for significant disease than ASC (61% vs historic 20%) and merits consideration in the triage of patients with atypical endocervical cells not otherwise specified. However, noncervical or other HPV-negative glandular neoplasia must be considered in all patients with AGC, particularly older patients.

show abstract

“…87 Researchers have expressed concern that the features of endocervical lesions in LBC may be subtle compared with smears. 73 However, four studies have shown that detection rates of glandular lesions using LBP are significantly higher than with conventional smears, [88][89][90][91] and specificity for glandular abnormality was also shown to be increased. 88,89 One studyreported a 50% decline in the AGC rate with LBP but a fivefold increase in the positive predictive value for AIS.…”

Section: Detection Of Glandular Lesionsmentioning

confidence: 99%

Liquid-Based Cytology: Evaluation of Effectiveness, Cost-Effectiveness, and Application to Present Practice

Cox

2004

J Natl Compr Canc Netw

View full text Add to dashboard Cite

This article reviews the data available as of 2004 on the effectiveness and cost-effectiveness of cervical screening with the two available cytologic methods, the conventional Papanicolaou (Pap; CP) smear and liquid-based cytology (LBC), and discusses the application of LBC to current practice. The majority of LBC studies are on the ThinPrep Pap Test (CYTYC, Boxsborough, MA) and the remainder are on SurePath (TriPath, Burlington, NC), which was previously known as AutoCyte Prep. LBC identified more low-grade squamous intraepithelial lesion (LSIL) Pap test results compared with paired conventional cytology in 17 of 21 ThinPrep and 9 of 12 SurePath “split-sample” studies considered to fulfill the criteria for inclusion in the British NHS Health Technology Assessment (HTA) evaluation of cervical cytology. In four of the six recent ThinPrep and one of two SurePath split-sample studies, more high-grade squamous intraepithelial lesion-positive (HSIL+) results were identified by LBC than by CP. All 15 “direct-to vial studies” meeting HTA criteria reported more LSIL+ results for LBC compared with CP, and all eight of the direct-to-vial studies reporting HSIL+ results separately showed increased detection of high-grade cytology interpretations. Fifteen studies met the criteria for evaluating sensitivity and specificity. Aggregate sensitivity for the CP was 71.5% and for LBC was 80.1%. Indirect comparisons of the two LBC methods did not detect a difference in sensitivity, and a meta-analysis of the six studies comparing specificity between CP and LBC found no difference. Other capabilities of LBC are improved specimen adequacy and the ability to do ancillary testing out of the liquid-based vial. In cost-effective analyses based on models of disease natural history and/or the clinical effectiveness of each screening modality, screening with CP was always dominated by screening with LBC. Primary cervical screening guidelines issued by the American Cancer Society in 2002 recommend repeating the cytology biannually if liquid-based and annually if conventional. The gain in sensitivity, apparent cost-effectiveness, and advantage of having a representative specimen for ancillary testing, support the use of LBC.

show abstract

Atypical glandular cells of undetermined significance in conventional cervical/vaginal smears and thin-layer preparations

Cited by 4 publications

References 9 publications

Clinical Significance of Atypical Glandular Cells on Cervical Cytology

Clinical Significance of Atypical Glandular Cells on Cervical Cytology

Atypical Glandular Cells of Undetermined Significance: Outcome Predictions Based on Human Papillomavirus Testing

Liquid-Based Cytology: Evaluation of Effectiveness, Cost-Effectiveness, and Application to Present Practice

Contact Info

Product

Resources

About