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논문KCI 등재

자궁경부 세포검사에서 비정형 선세포의 조직학적 상관성

Histologic Correlation of Atypical Glandular Cells in Cervical Smears

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초록

Background : The study evaluated the histologic correlation and clinical significance of atypical glandular cells (AGC) detected either on conventional smears (CS) or liquid-based cytology (LBC). Methods : Two hundred and seventy-seven (0.11%) of 261,925 cervical smears were interpreted as AGC by the Bethesda system 2001 from January 2006 to December 2008. Cytohistological correlation was performed on 192 cases. Results : The prevalence of AGC was 0.07% and 0.13% for CS and LBC smears, respectively. Distribution of AGC subcategories were as follows: atypical endometrial cells 53.8%, atypical endocervical cells 22.7%, atypical glandular cells 19.5%, atypical endocervical cells favoring neoplasia 2.2%, and atypical glandular cells favoring neoplasia 1.8%. Fifty-nine (27.4%) of 192 patients were confirmed as having clinically significant lesions comprising endometrial adenocarcinoma (12.5%), endometrial hyperplasia (6.0%), cervical adenocarcinoma (2.3%), high-grade squamous intraepithelial lesion (HSIL) (1.9%), low-grade SIL (1.9%), adenocarcinoma in situ (1.4%), or ovarian metastasis (1.4%). Conclusion : Compared with CS, LBC was presently associated with a higher prevalence of AGC. Histologic follow-up showed a very low HSIL rate compared to other studies. Endometrial adenocarcinoma was the most common malignant lesion detected because of increasing prevalence of endometrial adenocarcinoma, concentration on endometrial cytology, and introduction of LBC.

Abstract

Background : The study evaluated the histologic correlation and clinical significance of atypical glandular cells (AGC) detected either on conventional smears (CS) or liquid-based cytology (LBC). Methods : Two hundred and seventy-seven (0.11%) of 261,925 cervical smears were interpreted as AGC by the Bethesda system 2001 from January 2006 to December 2008. Cytohistological correlation was performed on 192 cases. Results : The prevalence of AGC was 0.07% and 0.13% for CS and LBC smears, respectively. Distribution of AGC subcategories were as follows: atypical endometrial cells 53.8%, atypical endocervical cells 22.7%, atypical glandular cells 19.5%, atypical endocervical cells favoring neoplasia 2.2%, and atypical glandular cells favoring neoplasia 1.8%. Fifty-nine (27.4%) of 192 patients were confirmed as having clinically significant lesions comprising endometrial adenocarcinoma (12.5%), endometrial hyperplasia (6.0%), cervical adenocarcinoma (2.3%), high-grade squamous intraepithelial lesion (HSIL) (1.9%), low-grade SIL (1.9%), adenocarcinoma in situ (1.4%), or ovarian metastasis (1.4%). Conclusion : Compared with CS, LBC was presently associated with a higher prevalence of AGC. Histologic follow-up showed a very low HSIL rate compared to other studies. Endometrial adenocarcinoma was the most common malignant lesion detected because of increasing prevalence of endometrial adenocarcinoma, concentration on endometrial cytology, and introduction of LBC.

참고문헌 (10)

  1. National Cancer Institute Workshop, "The 1988 Bethesda system for reporting cervical", vaginal cytologic diagnoses, 1989, pp.262, 931~934
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  5. Canfell K, "Normal endometrial cells in cervical cytology: systematic review of prevalence and relation to significant endometrial pathology", J Med Screen, 15, pp.188~198 (2008)
  6. Thrall M, "Liquid-based Papanicolaou test (SurePath) interpretations before histologic diagnosis of endometrial hyperplasias and carcinomas: study of 272 cases classified by the 2001 Bethesda system", Cancer, 111, pp.217~223 (2007)
  7. Kim TJ, "Clinical evaluation of follow-up methods and results of atypical glandular cells of undetermined significance (AGUS) detected on cervicovaginal pap smears", Gynecol Oncol, 73, pp.292~298 (1999)
  8. Schnatz PF, "Clinical significance of atypical glandular cells on cervical cytology", Obstet Gynecol, 107, pp.701~708 (2006)
  9. Selvaggi SM, "Cytologic features of high-grade squamous intraepithelial lesions involving endocervical glands on ThinPrep cytology", Diagn Cytopathol, 26, pp.181~185 (2002)
  10. Selvaggi SM, "Cytologic features of squamous cell carcinoma in situ involving endocervical glands in endocervical cytobrush specimens", Acta Cytol, 38, pp.687~692 (1994)

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