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Korean Journal of Obstetrics & Gynecology 2006;49(9):1908-1918.
Published online September 1, 2006.
Risk factors of High Grade Lesions in Glandular Cell Abnormalities on Cervical Cytology.
Seung Hun Song, Kyung Jin Min, Jong Hyun Lee, Jae Kwan Lee, Nak Woo Lee, Ho Suk Saw, Jae Seong Kang, Kyu Wan Lee
Department of Obstetrics and Gynecology, School of Medicine, Korea University, Seoul, Korea. jklee38@korea.ac.kr
To identify the risk factors that may predict high grade lesions in glandular cell abnormalities on cervical cytology. METHODS: This study was performed from January 2002 to December 2005 and included 87 cases of glandular cell abnormalities on Pap smear. Among them, 65 (74.7%) cases were atypical glandular cells (AGC) and 22 (25.3%) cases were AGC, favor neoplastic. The histologic diagnoses were classified as low grade lesions [normal, cervical intraepithelial neoplasia (CIN) I, and simple hyperplasia without atypia] and high grade lesions [CIN II/III, adenocarcinoma in situ (AIS), and invasive cancer]. RESULTS: Fifty-three (60.9%) cases had negative biopsies or cervicitis. Twenty-five cases had cervical lesions including one CIN I, ten CIN II/III, two AIS, twelve invasive cancers. There were 7 endometrial lesions: 5 adenocarcinomas and 2 malignant mixed mullerian tumors. Two patients had one tubal cancer and one CIN II with simple hyperplasia without atypia. High-risk human papillomavirus (HPV) positive and AGC, favor neoplastic cases were significantly associated with high grade lesions (OR 15.4, CI 2.2-109.7; OR 7.0, CI 1.1-42.8). In the cervix, only high-risk HPV positive were significantly associated with high grade lesions (OR 64.6, CI 4.5-930.8). In the endometrium, age, menopausal status, and cytologic classification were significantly associated with low grade lesions or high grade lesions (p<0.05). CONCLUSION: High-risk HPV DNA detection was strongly associated with high grade lesions in women with glandular cell abnormalites on their Pap smear. These results suggest that HPV testing may be useful as a triage of the management in women with glandular cell abnormalities.
Key Words: Atypical glandular cells, Human papillomavirus, Cervical cytology
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