Atypical Glandular Cells of Undetermind Significances (AGUS) ; Histopathologic Results and the Significance of the HPV DNA Detection. |
Chan Joo Kim, Tae Chul Park, Jong Sup Park, Jun Mo Lee, Seung Jo Kim, Sung Eun NamKoong |
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Abstract |
OBJECTIVES AGUS often reflects an immediate cervical cancer precursor such as a HSIL mimicking an endocervical glandular lesion. In this study, we attempted to assess the clinical significance of a cytologic diagnosis of atypical glandular cells of undetermined significance (AGUS) and determine the usefulness of the human papillomavirus (HPV) DNA testing as the triage strategies in evaluating AGUS. METHODS: Between 1994 and 1998, 67,730 Papanicolaou smears were evaluated at Kangnam and Uijongbu St Mary's Hospital. There were 87 (0.13%) cases of AGUS smears during that time. Colposcopy was performed on all women, and HPV DNA testing was performed on 11 persons. RESULTS: Mean age of these patients was 45.8 years. Histologic diagnosis of AGUS were kolocytosis and CIN-I in 6 (6.9%), CIS in one, endometrial hyperplasia in 2 (2.3%), endometrial adenocarcinoma in 7 (8.0%), cervical adenocarcinoma in 14 (16.1%) and cervical squamous cell carcinoma in 2 (2.3%) cases. Endometriosis was 8.9% under 46 years old and none in over 46. CIN was 8.9% and 7.2%, respectively. Cervical adenocarcinoma was 6.7% under 46 and 19.1% over 46. Endometrial cancer was 4.4% and 11.9%, respectively. The risk of cervical cancer and endometrial cancer was high in the AGUS with = 46 years old. The sensitivity for the prediction of CIN and cervical cancer by Hybrid Capture HPV testing was 75% and negative predictive value was 87.5%. CONCLUSIONS: A significant proportion of women with a cytologic diagnosis of AGUS have abnormal histopathology. Use of HPV DNA testing in patients with AGUS may provide improvements in the management of woman with AGUS. |
Key Words:
AGUS (Atypical Glandular Cells of Undetermined Significance), HPV (Human papilloma virus), Cervical Cancer |
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