Clinical Diagnostic Value of Atypical Glandular Cells in Cervical Cytology: A Single Center Experience From China.

IF 2.4 4区 医学 Q2 OBSTETRICS & GYNECOLOGY
Journal of Lower Genital Tract Disease Pub Date : 2023-07-01 Epub Date: 2023-03-22 DOI:10.1097/LGT.0000000000000730
Jingjing Xiao, Yingxin Gong, Fang Chen, Limei Chen, Yu Xie, Long Sui
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引用次数: 0

Abstract

Objective: This study aimed to investigate the diagnostic value of atypical glandular cells (AGCs) by analyzing the prevalence and histopathology of AGCs according to cervical cytology.

Methods: The authors retrospectively reviewed and analyzed the demographic characteristics and histopathological outcomes including pathological diagnosis, pathological site, and epithelial distribution of the AGC cases that were diagnosed by cervical cytology.

Results: A total of 387 AGC patients with follow-up records were included. Among them, the prevalence of AGC-not otherwise specified (NOS) and AGC-favor neoplastic (FN) was 73.39% (284/387) and 26.62% (103/387), respectively. The high-risk human papillomavirus (hr-HPV)-positive rate was higher in AGC-FN than in AGC-NOS ( p = .002). The difference in pathological severity was statistically significant between hr-HPV-positive and negative AGC patients ( p = .010). Hr-HPV-positive AGC mainly occurs in cervical diseases, whereas hr-HPV-negative AGC is mainly related to endometrial lesions. Precancerous or malignant lesions were found in 36.43% (141/387) of AGC cases and were more commonly seen in AGC-FN than AGC-NOS ( p < .001). The histopathological severity and the incidence of uterine disease were higher among AGC women aged 40 years and older than those younger than 40 years ( p < .05). The possibility of the abnormal origin of glandular epithelial was higher than that of squamous epithelial in AGC patients aged 40 years and older ( p = .0003).

Conclusions: The management of AGC women by age triage is reasonable because the incidence of the glandular epithelial lesion and uterine disease increases in AGC patients 40 years or older. Standardized clinical diagnosis and regular follow-up are recommended for all AGC patients.

宫颈细胞学中非典型腺细胞的临床诊断价值:来自中国的单中心经验
目的本研究旨在通过分析宫颈细胞学检查发现的非典型腺细胞(AGC)的发病率和组织病理学,探讨其诊断价值:作者回顾性分析了经宫颈细胞学诊断的AGC病例的人口统计学特征和组织病理学结果,包括病理诊断、病理部位和上皮分布:结果:共纳入了 387 例有随访记录的 AGC 患者。结果:共纳入 387 例有随访记录的 AGC 患者,其中未明确诊断的 AGC(NOS)和易癌变的 AGC(FN)的发病率分别为 73.39%(284/387)和 26.62%(103/387)。AGC-FN的高危人乳头瘤病毒(hr-HPV)阳性率高于AGC-NOS(P = .002)。hr-HPV 阳性和阴性 AGC 患者的病理严重程度差异具有统计学意义 ( p = .010)。hr-HPV阳性AGC主要发生在宫颈疾病中,而hr-HPV阴性AGC主要与子宫内膜病变有关。36.43%的AGC病例(141/387)发现了癌前病变或恶性病变,AGC-FN比AGC-NOS更常见(P < .001)。40岁及40岁以上的AGC妇女的组织病理学严重程度和子宫疾病发生率均高于40岁以下的妇女(P < .05)。在40岁及以上的AGC患者中,腺上皮异常起源的可能性高于鳞状上皮(P = .0003):结论:对AGC妇女进行年龄分流管理是合理的,因为腺上皮病变和子宫疾病的发病率在40岁及以上的AGC患者中有所增加。建议对所有 AGC 患者进行标准化临床诊断和定期随访。
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来源期刊
Journal of Lower Genital Tract Disease
Journal of Lower Genital Tract Disease OBSTETRICS & GYNECOLOGY-
CiteScore
6.80
自引率
8.10%
发文量
158
审稿时长
6-12 weeks
期刊介绍: The Journal of Lower Genital Tract Disease is the source for the latest science about benign and malignant conditions of the cervix, vagina, vulva, and anus. The Journal publishes peer-reviewed original research original research that addresses prevalence, causes, mechanisms, diagnosis, course, treatment, and prevention of lower genital tract disease. We publish clinical guidelines, position papers, cost-effectiveness analyses, narrative reviews, and systematic reviews, including meta-analyses. We also publish papers about research and reporting methods, opinions about controversial medical issues. Of particular note, we encourage material in any of the above mentioned categories that is related to improving patient care, avoiding medical errors, and comparative effectiveness research. We encourage publication of evidence-based guidelines, diagnostic and therapeutic algorithms, and decision aids. Original research and reviews may be sub-classified according to topic: cervix and HPV, vulva and vagina, perianal and anal, basic science, and education and learning. The scope and readership of the journal extend to several disciplines: gynecology, internal medicine, family practice, dermatology, physical therapy, pathology, sociology, psychology, anthropology, sex therapy, and pharmacology. The Journal of Lower Genital Tract Disease highlights needs for future research, and enhances health care. The Journal of Lower Genital Tract Disease is the official journal of the American Society for Colposcopy and Cervical Pathology, the International Society for the Study of Vulvovaginal Disease, and the International Federation of Cervical Pathology and Colposcopy, and sponsored by the Australian Society for Colposcopy and Cervical Pathology and the Society of Canadian Colposcopists.
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