Predictive value of diagnoses of endocervical glandular abnormalities in cervical smears

Segal, Amanda; Frost, Felicity; Miranda, Alina; Fletcher, Christine; Sterrett, Gregory F.

doi:10.1080/00313020307558

Cited by 5 publications

(7 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There has Address correspondence and reprint requests to Rita Demopoulos, 24 Sycamore Road, Scarsdale, New York 10583. E-mail: rita.demopoulos@ med.nyu.edu (4)(5)(6)(7)(8)(9)(10). However, we found no studies in the literature that focused on the truly negative Pap smears in patients with invasive endocervical adenocarcinoma, which correlated the Pap smears with the pathology findings for a possible explanation.…”

mentioning

confidence: 74%

Obstacles to the Early Detection of Endocervical Adenocarcinoma

Kalir

Simsir

et al. 2005

International Journal of Gynecological Pathology

View full text Add to dashboard Cite

We observed that the ratio of in situ to invasive carcinomas of the cervix is significantly greater for squamous than for glandular lesions. We wondered whether Pap smears were less effective for the identification of in situ glandular lesions. The purpose of this study was to determine if the location, extent of disease, and growth patterns of endocervical adenocarcinomas influence the ability to detect malignant cells by Pap smears. Medical records, doctor's office records, and all pathology materials (reports and slides) including Pap smears, biopsies, LEEP/cone biopsies, and hysterectomy specimens from 53 consecutive patients diagnosed with endocervical adenocarcinomas were examined at New York University Medical Center (a total of 654 pathology slides and 51 Pap smears were reviewed). Findings were correlated for each patient using gross descriptions and histopathology and stratified by location/extent of disease and growth pattern (exophytic or endophytic or both). Ten patients had in situ disease, seven (70%) of which involved the transformation zone (TZ); all seven of these were identified by Pap smears. In contrast, of the other three cases that did not involve the TZ but were confined to the endocervix, only one was identified by Pap smear. Forty-three patients had invasive disease. Twenty involved the TZ, and 23 involved the endocervix but spared the TZ. Of the 20 tumors involving the TZ, 11 (55%) were identified by Pap smears, whereas of the 23 sparing the TZ, 11 (47.8%) were diagnosed by Pap smear. Among the 23 patients with invasive disease that spared the TZ, 6 (26%) had a documented history of negative Pap smears at New York University within 3 years of diagnosis. Conversely only 1 of the 20 patients with TZ involvement had a history of negative Pap smears, and 3 patients in this group denied having had Pap smears for several years. Including all 53 patients, a significantly higher proportion were not detectable by Pap smear if the TZ was spared (54% versus 25%, p = 0.036). Of the 23 invasive cancers that spared the TZ, 6 (14%) had verified negative Pap smears. These lesions did not shed malignant cells onto Pap smears. Noteworthy was the finding that two of these six lesions extended from the endocervix upward, through the stroma, and into the endomyometrium of the lower uterine segment. Four extended downward into the exocervix through the stroma, sparing the surface mucosa; one reached the upper vagina. All six displayed an endophytic growth pattern.

show abstract

mentioning

confidence: 74%

Obstacles to the Early Detection of Endocervical Adenocarcinoma

Kalir

Simsir

et al. 2005

International Journal of Gynecological Pathology

View full text Add to dashboard Cite

show abstract

“…20 Unfortunately, however, this new nomenclature has not solved the basic problem, how to improve the accuracy of cytologic diagnosis of cervical AC and its precursor lesions. 8,12,13,[18][19][20][21] With increasing evidence suggesting the etiolog- ic role of oncogenic human papillomaviruses (HPVs) in cervical AC, 8,22 the recent past has witnessed an influx of reports implicating the utility of HPV testing in the diagnosis of AIS, AC and their precursors. 23,24 This is exactly what happened few years earlier for SCC and its precursors, when Pap smear screening was recommended to be replaced or supplemented by HPV testing; that debate still continues.…”

Section: Editorialmentioning

confidence: 99%

“…8 However, the fact that AIS patients are older than women with squamous CIS 27 and that the reverse is true for AC and SCC 16 could imply that the progression of CGIN to AIS must be more slow than the progression of CIN lesions to CIS; in contrast, AIS should progress to invasive AC significantly more rapidly than does CIS into SCC, and that, indeed, seems to be the case. 31 This would leave ample time for detection of CGIN (but not necessarily AIS), 31 provided that the glandular precursor lesions can be accurately diagnosed 8,12,13,[17][18][19][20][21] and that screening coverage is adequate. [1][2][3][4] To answer the question in the title of this editorial, one can conclude that any measures increasing the coverage of screening and the accuracy of cytologic diagnosis of glandular precursor lesions (CGIN, AIS) would contribute toward reduction of the incidence of, morbidity from and mortality from invasive AC.…”

Section: Editorialmentioning

confidence: 99%

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

Syrjänen¹

2004

Acta Cytologica

View full text Add to dashboard Cite

“…Therefore, policy formation about the appropriate investigation of women with these abnormalities must rely upon Australian publications. Recent Australian publications have been made by laboratories in Western Australia and New South Wales 8–12 …”

Section: Discussionmentioning

confidence: 99%

“…Segal et al 10 evaluated the positive predictive value of cytology reports issued between 1992 and 1998, with follow‐up histology usually within 6–24 months but ranging up to 9 years. Among nine cases in which the cytology was reported as definite AIS, seven (78%) were confirmed on histology as having high‐grade disease.…”

Section: Discussionmentioning

confidence: 99%