Clinical evaluation of atypical glandular cells of undetermined significance upon cervical cytologic examination in Israeli Jewish women

• Published in: British journal of cancer Vol. 90; no. 11; pp. 2194 - 2196
• Main Authors: GUTMAN, G, BACHAR, R, PAUZNER, D, LESSING, J. B, SCHEJTER, E
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 01.06.2004
• Subjects: Adult; Biological and medical sciences; Biopsy; Cancer research; Carcinoma, Squamous Cell - epidemiology; Carcinoma, Squamous Cell - pathology; Cervical Intraepithelial Neoplasia - epidemiology; Cervical Intraepithelial Neoplasia - pathology; Cervix; Cervix Uteri - cytology; Colposcopy; Female; Humans; Israel; Jews; Medical research; Medical sciences; Middle Aged; Molecular and Cellular Pathology; Pap smear; Retrospective Studies; Risk Factors; Tumors; Uterine Cervical Dysplasia - epidemiology; Uterine Cervical Dysplasia - pathology; Uterine Cervical Neoplasms - epidemiology; Uterine Cervical Neoplasms - pathology; Israel; Tel Aviv Israel; Human; Cancerology; ASCUS; Female; Atypical; AGUS; Uterine cervix; Malignant tumor; Intraepithelial neoplasia; cervical intraepithelial neoplasia; bethesda system
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/sj.bjc.6601874

The adjusted incidence of cervical carcinoma among Israeli Jewish women is approximately 5 out of 100 000. This retrospective study sought to determine the clinical implications of finding atypical glandular cells of undetermined significance (AGUS) in cervical cytologic specimens in this population. Cervical cytologic examinations during January 2001-June 2003 diagnosed as AGUS were identified by a computerised database. Medical records were reviewed to determine the presence or absence of associated significant pathologic conditions of the cervix and identified 45 out of 11 800 patients (0.38%) with AGUS. AGUS was the only cytologic diagnosis in 14 patients, while 31 patients had both AGUS and an additional atypical squamous cell of undetermined significance (ASCUS). All subjects underwent colposcopy, endocervical curettage, and cervical biopsy. A clinically significant diagnosis (cervical intraepithelial neoplasia (CIN) II, CIN III, or carcinoma) was made in 24 patients (53.3%), including cancer in three (6.7%): one had microinvasive adenocarcinoma and two had microinvasive squamous cell carcinoma. Squamous carcinoma coexisting with a clinically significant lesion carried a risk of 61.3%, compared with a risk of 35.7% for AGUS alone (P=0.20). Detection of AGUS during cervical cytologic screening, especially with a coexisting ASCUS, indicates the existence of serious pathologic processes; management by cervical colposcopy, endocervical curettage, and cervical biopsy is recommended.