Clinical utility of atypical glandular cells (AGC) classification: Cytohistologic comparison and relationship to HPV results

Teresa P. Diaz-Montes, Maryam Armin Farinola, Marianna L. Zahurak, Robert E. Bristow, Dorothy Rosenthal

Research output: Contribution to journalArticle

Abstract

Objectives.: To determine the utility of the category of atypical glandular cells (AGC) in the management of patients with putative cervical neoplasia and to correlate HPV-DNA test results when available. Methods.: The Johns Hopkins Hospital cytopathology records of 50,668 women patients were searched for all liquid-based gynecologic cytology (LBP) results of Atypical Glandular cells of Undetermined Significance (AGUS) and AGC from January 1, 2001 through December 31, 2003, yielding 98 patients (0.19%). Oncogenic HPV-DNA tests were performed on the residual fluids of 43 of these patients, 37 of whom had follow-up biopsy. During the period of January 1, 2000 and December 31, 2002, we identified 237 patients (0.58%) with conventional Pap smears in the AGUS or AGC category, among 41,024 conventional smears collected contemporaneously. To avoid confusion in this paper, AGC will be used to replace those results that originally were AGUS. Results.: Following the 98 LBP AGC interpretations, 24 lesions (33.8%) were discovered out of 71 biopsies. HPV-DNA tests were performed on the residual of 43 LBPs, 18 (41.9%) were positive for oncogenic HPV. Only 37 patients had follow-up biopsy and 15 (40.5%) were positive for oncogenic HPV, of which 40% (6/15) had a significant lesion. Of the 237 conventional AGC Paps, 18 lesions (15.3%) were discovered out of 118 biopsies. Conclusions.: Comparison of liquid-based and conventional Pap tests revealed a significant difference (33.8% vs. 15.3% respectively) (OR: 2.84, 95% CI: 1.4-5.73, p = 0.004) in the detection of glandular and squamous lesions. HPV testing may prove beneficial to triage AGC patients with negative colposcopic findings and positive HPV results.

Original languageEnglish (US)
Pages (from-to)366-371
Number of pages6
JournalGynecologic Oncology
Volume104
Issue number2
DOIs
StatePublished - Feb 2007

Fingerprint

Human Papillomavirus DNA Tests
Biopsy
Papanicolaou Test
Hospital Records
Triage
Cell Biology
Neoplasms

Keywords

  • Adenocarcinoma in situ
  • AGC
  • Endocervical adenocarcinoma
  • HPV

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Clinical utility of atypical glandular cells (AGC) classification : Cytohistologic comparison and relationship to HPV results. / Diaz-Montes, Teresa P.; Farinola, Maryam Armin; Zahurak, Marianna L.; Bristow, Robert E.; Rosenthal, Dorothy.

In: Gynecologic Oncology, Vol. 104, No. 2, 02.2007, p. 366-371.

Research output: Contribution to journalArticle

Diaz-Montes, Teresa P. ; Farinola, Maryam Armin ; Zahurak, Marianna L. ; Bristow, Robert E. ; Rosenthal, Dorothy. / Clinical utility of atypical glandular cells (AGC) classification : Cytohistologic comparison and relationship to HPV results. In: Gynecologic Oncology. 2007 ; Vol. 104, No. 2. pp. 366-371.
@article{f25d1ff89f8646e6840140c7ade963ca,
title = "Clinical utility of atypical glandular cells (AGC) classification: Cytohistologic comparison and relationship to HPV results",
abstract = "Objectives.: To determine the utility of the category of atypical glandular cells (AGC) in the management of patients with putative cervical neoplasia and to correlate HPV-DNA test results when available. Methods.: The Johns Hopkins Hospital cytopathology records of 50,668 women patients were searched for all liquid-based gynecologic cytology (LBP) results of Atypical Glandular cells of Undetermined Significance (AGUS) and AGC from January 1, 2001 through December 31, 2003, yielding 98 patients (0.19{\%}). Oncogenic HPV-DNA tests were performed on the residual fluids of 43 of these patients, 37 of whom had follow-up biopsy. During the period of January 1, 2000 and December 31, 2002, we identified 237 patients (0.58{\%}) with conventional Pap smears in the AGUS or AGC category, among 41,024 conventional smears collected contemporaneously. To avoid confusion in this paper, AGC will be used to replace those results that originally were AGUS. Results.: Following the 98 LBP AGC interpretations, 24 lesions (33.8{\%}) were discovered out of 71 biopsies. HPV-DNA tests were performed on the residual of 43 LBPs, 18 (41.9{\%}) were positive for oncogenic HPV. Only 37 patients had follow-up biopsy and 15 (40.5{\%}) were positive for oncogenic HPV, of which 40{\%} (6/15) had a significant lesion. Of the 237 conventional AGC Paps, 18 lesions (15.3{\%}) were discovered out of 118 biopsies. Conclusions.: Comparison of liquid-based and conventional Pap tests revealed a significant difference (33.8{\%} vs. 15.3{\%} respectively) (OR: 2.84, 95{\%} CI: 1.4-5.73, p = 0.004) in the detection of glandular and squamous lesions. HPV testing may prove beneficial to triage AGC patients with negative colposcopic findings and positive HPV results.",
keywords = "Adenocarcinoma in situ, AGC, Endocervical adenocarcinoma, HPV",
author = "Diaz-Montes, {Teresa P.} and Farinola, {Maryam Armin} and Zahurak, {Marianna L.} and Bristow, {Robert E.} and Dorothy Rosenthal",
year = "2007",
month = "2",
doi = "10.1016/j.ygyno.2006.09.001",
language = "English (US)",
volume = "104",
pages = "366--371",
journal = "Gynecologic Oncology",
issn = "0090-8258",
publisher = "Academic Press Inc.",
number = "2",

}

TY - JOUR

T1 - Clinical utility of atypical glandular cells (AGC) classification

T2 - Cytohistologic comparison and relationship to HPV results

AU - Diaz-Montes, Teresa P.

AU - Farinola, Maryam Armin

AU - Zahurak, Marianna L.

AU - Bristow, Robert E.

AU - Rosenthal, Dorothy

PY - 2007/2

Y1 - 2007/2

N2 - Objectives.: To determine the utility of the category of atypical glandular cells (AGC) in the management of patients with putative cervical neoplasia and to correlate HPV-DNA test results when available. Methods.: The Johns Hopkins Hospital cytopathology records of 50,668 women patients were searched for all liquid-based gynecologic cytology (LBP) results of Atypical Glandular cells of Undetermined Significance (AGUS) and AGC from January 1, 2001 through December 31, 2003, yielding 98 patients (0.19%). Oncogenic HPV-DNA tests were performed on the residual fluids of 43 of these patients, 37 of whom had follow-up biopsy. During the period of January 1, 2000 and December 31, 2002, we identified 237 patients (0.58%) with conventional Pap smears in the AGUS or AGC category, among 41,024 conventional smears collected contemporaneously. To avoid confusion in this paper, AGC will be used to replace those results that originally were AGUS. Results.: Following the 98 LBP AGC interpretations, 24 lesions (33.8%) were discovered out of 71 biopsies. HPV-DNA tests were performed on the residual of 43 LBPs, 18 (41.9%) were positive for oncogenic HPV. Only 37 patients had follow-up biopsy and 15 (40.5%) were positive for oncogenic HPV, of which 40% (6/15) had a significant lesion. Of the 237 conventional AGC Paps, 18 lesions (15.3%) were discovered out of 118 biopsies. Conclusions.: Comparison of liquid-based and conventional Pap tests revealed a significant difference (33.8% vs. 15.3% respectively) (OR: 2.84, 95% CI: 1.4-5.73, p = 0.004) in the detection of glandular and squamous lesions. HPV testing may prove beneficial to triage AGC patients with negative colposcopic findings and positive HPV results.

AB - Objectives.: To determine the utility of the category of atypical glandular cells (AGC) in the management of patients with putative cervical neoplasia and to correlate HPV-DNA test results when available. Methods.: The Johns Hopkins Hospital cytopathology records of 50,668 women patients were searched for all liquid-based gynecologic cytology (LBP) results of Atypical Glandular cells of Undetermined Significance (AGUS) and AGC from January 1, 2001 through December 31, 2003, yielding 98 patients (0.19%). Oncogenic HPV-DNA tests were performed on the residual fluids of 43 of these patients, 37 of whom had follow-up biopsy. During the period of January 1, 2000 and December 31, 2002, we identified 237 patients (0.58%) with conventional Pap smears in the AGUS or AGC category, among 41,024 conventional smears collected contemporaneously. To avoid confusion in this paper, AGC will be used to replace those results that originally were AGUS. Results.: Following the 98 LBP AGC interpretations, 24 lesions (33.8%) were discovered out of 71 biopsies. HPV-DNA tests were performed on the residual of 43 LBPs, 18 (41.9%) were positive for oncogenic HPV. Only 37 patients had follow-up biopsy and 15 (40.5%) were positive for oncogenic HPV, of which 40% (6/15) had a significant lesion. Of the 237 conventional AGC Paps, 18 lesions (15.3%) were discovered out of 118 biopsies. Conclusions.: Comparison of liquid-based and conventional Pap tests revealed a significant difference (33.8% vs. 15.3% respectively) (OR: 2.84, 95% CI: 1.4-5.73, p = 0.004) in the detection of glandular and squamous lesions. HPV testing may prove beneficial to triage AGC patients with negative colposcopic findings and positive HPV results.

KW - Adenocarcinoma in situ

KW - AGC

KW - Endocervical adenocarcinoma

KW - HPV

UR - http://www.scopus.com/inward/record.url?scp=33846343659&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33846343659&partnerID=8YFLogxK

U2 - 10.1016/j.ygyno.2006.09.001

DO - 10.1016/j.ygyno.2006.09.001

M3 - Article

C2 - 17049972

AN - SCOPUS:33846343659

VL - 104

SP - 366

EP - 371

JO - Gynecologic Oncology

JF - Gynecologic Oncology

SN - 0090-8258

IS - 2

ER -