Is Improved Detection of Adenocarcinoma in Situ by Screening a Key to Reducing the Incidence of Cervical Adenocarcinoma?

Syrjänen, Karí

doi:10.1159/000326427

Cited by 13 publications

(13 citation statements)

References 20 publications

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“…AIS was first described by Friedell and Mackay in 1953. Since then, studies have been done on this entity, and, after 30 years, it has been considered as a precursor lesion of invasive adenocarcinoma [18] .…”

Section: Discussionmentioning

confidence: 99%

“…On the contrary, women with AGC and HPV negativity provide good reassurance of the absence of any cervical abnormality, provided endometrial and upper genital tract carcinomas are ruled out. Hence, increased detection of AGC is best achieved by a combined approach of cytological Pap screening, HPV testing as well as immunohistochemistry for molecular markers such as p16 [6,18,20] .…”

Section: Discussionmentioning

confidence: 99%

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The Significance of Glandular Cells on Conventional Cervicovaginal Smears: Experience from a Tertiary Care Hospital in Coastal India

Suresh

Kini

Minal³

et al. 2017

Acta Cytologica

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Introduction: Glandular lesions of the female genital tract (FGT) are quite uncommon compared to squamous lesions. Their cytological diagnosis is difficult because of their architectural and cytological complexity, as well as the lack of experience of many cytopathologists in this field. The aim of this study was to determine the significance of Papanicolaou (Pap) smears in the diagnosis of glandular FGT lesions. Methodology: All Pap smears reported during the period of January 2012 to December 2013 were retrieved. Cytohistopathological correlation was done. Results: Among 7,609 Pap smears, squamous epithelial abnormalities were seen in 110 cases (1.5%) and glandular cell abnormalities in 32 cases (0.42%). Among the glandular abnormalities, we encountered 18 cases of atypical glandular cells (AGC) not otherwise specified, 4 cases of endocervical-type AGC and 4 cases favoring neoplastic-type AGC, 2 cases of adenocarcinoma of the endocervical type, 3 cases of adenocarcinoma of the endometrial type, and 1 case of extrauterine adenocarcinoma. Histopathological correlation was available in 12 cases (37.5%). Eighty-three percent showed premalignant or malignant lesions on histopathology. Conclusion: As glandular epithelial lesions are associated with premalignant and malignant FGT lesions, in patients with cytological diagnosis of glandular epithelial abnormalities, it is mandatory to undergo colposcopic examination with endocervical and endometrial curettage.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Significance of Glandular Cells on Conventional Cervicovaginal Smears: Experience from a Tertiary Care Hospital in Coastal India

Suresh

Kini

Minal³

et al. 2017

Acta Cytologica

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“…Cervical adenocarcinomas have significantly increased, whereas cervical squamous carcinomas have shown a declining trend, since the advent of Papanicolaou (Pap) test screening and subsequent liquid‐based cytology. The interpretation of atypical glandular cells (AGC) for the early detection of female genital tract glandular neoplasia remains a major challenge in gynecologic cytopathology . The limited reproducibility of AGC Pap test interpretations makes it less reliable .…”

Section: Introductionmentioning

confidence: 99%

Clinical significance of atypical glandular cells in Pap tests: An analysis of more than 3000 cases at a large academic women's center

Pradhan

Ocque

et al. 2016

Cancer Cytopathology

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BACKGROUND The interpretation of atypical glandular cells (AGC) in Papanicolaou (Pap) tests and screening for glandular neoplasia remain challenging. METHODS Pap tests with an AGC interpretation from January 2008 to December 2013 were retrieved from a pathology database, and cases with histologic follow‐up within 1 year were included in the study. RESULTS There were 589,830 Pap tests during the study period, and 3709 cases (0.6%) were reported as AGC, which included the following: AGC, not otherwise specified (52.0%); atypical endocervical cells (28.0%); and other categories. There were 3007 cases (81.1%) with histologic follow‐up results within 1 year. Cervical intraepithelial neoplasia 2/3 (CIN2/3), cervical adenocarcinoma in situ (AIS)/adenocarcinoma, and endometrial carcinoma were identified in 5.6%, 1.9%, and 5.5% of cases, respectively. Glandular neoplasia was more likely to be identified in cases with pure AGC subcategories than cases with AGC and squamous abnormalities. Endometrial neoplasia was more likely to be identified in cases with atypical endometrial cells than other categories. Overall, the most common severe abnormality on histologic follow‐up was CIN2/3. Although CIN2/3 was the most common severe lesion in patients younger than 30 years (10.0%) and in patients aged 30 to 49 years (6.4%), endometrial carcinoma was the most common lesion in women who were 50 years old or older (13.7%). Endocervical glandular lesions (AIS and adenocarcinoma) occurred in only 1.9% of women. CONCLUSIONS AGC subtypes and ages significantly affect histological follow‐up results; 90.5% of cases with carcinoma on histologic follow‐up were either endometrial or metastatic carcinoma. This study supports the recommendation that women with AGC Pap test results should be followed up with both endocervical and endometrial sampling. Cancer Cytopathol 2016;124:589‐95. © 2016 American Cancer Society.

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“…Despite a rising incidence of CAC in many countries, [1][2][3][4] there is emerging evidence that cytologic detection of the precursor lesion, adenocarcinoma in situ (AIS), may reduce the incidence of and mortality from CAC. 1,[5][6][7][8][9][10] Although many countries have replaced conventional cervical cytology with liquid-based cytology (LBC), currently in Australia, LBC, mostly ThinPrep (TP), is used as an optional adjunctive test to the conventional Papanicolaou (Pap) smear (PS). Although this may appear cumbersome, one advantage is that it gives us the opportunity to compare paired samples and, consequently, to learn how to recognize the corresponding morphologic appearances on TP slides.…”

mentioning

confidence: 99%

Comparative sensitivities of ThinPrep and Papanicolaou smear for adenocarcinoma in situ (AIS) and combined AIS/high-grade squamous intraepithelial lesion (HSIL): Comparison with HSIL

Roberts

Thurloe²

2007

Cancer

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Is Improved Detection of Adenocarcinoma in Situ by Screening a Key to Reducing the Incidence of Cervical Adenocarcinoma?

Cited by 13 publications

References 20 publications

The Significance of Glandular Cells on Conventional Cervicovaginal Smears: Experience from a Tertiary Care Hospital in Coastal India

The Significance of Glandular Cells on Conventional Cervicovaginal Smears: Experience from a Tertiary Care Hospital in Coastal India

Clinical significance of atypical glandular cells in Pap tests: An analysis of more than 3000 cases at a large academic women's center

Comparative sensitivities of ThinPrep and Papanicolaou smear for adenocarcinoma in situ (AIS) and combined AIS/high-grade squamous intraepithelial lesion (HSIL): Comparison with HSIL

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