- Volume 17 Issue 1
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High-grade Cervical Histopathology in Women with Atypical Glandular Cell Cytology
- Watcharanon, Waranya (Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University) ;
- Luanratanakorn, Sanguanchoke (Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University) ;
- Kleebkaow, Pilaiwan (Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University) ;
- Chumworathayi, Bandit (Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University) ;
- Temtanakitpaisan, Amornrat (Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University) ;
- Kietpeerakool, Chumnan (Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University)
- Published : 2016.02.05
This study was undertaken to evaluate the prevalence of underlying significant lesions among women referred for colposcopy after atypical glandular cell (AGC) smears and the associated risks. The present study reviewed data from women with AGC smears undergoing colposcopy at the Colposcopy Clinic, Faculty of Medicine, Khon Kaen University, Thailand between January 2001 to December 2014. Significant lesions included cervical intraepithelial neoplasia grade 2-3, adenocarcinoma in situ, endometrial hyperplasia, and cancer. During the study period, 170 women with AGC cytology were reviewed. The mean age was 45.7 years. Thirty-eight women (22.4%) were postmenopausal. Eighteen smears (10.6%) were further subclassified as AGC-favor neoplasia (AGC-FN). In total, significant lesions were noted in 27 women (15.9%; 95%CI, 7.8%-18.3%). Thirteen women (7.6%, 95%CI, 4.1%-12.7%) were found to have cervical cancer or endometrial cancer. Two variables were independently associated with an increased risk of significant histopathology results: level of educational attainment (secondary level or lower versus bachelor degree or higher) and types of AGC (AGC versus AGC-FN). Women who had low level of education and those with AGC-FN were at the higher risk of significant lesions (OR, 3.16; 95%CI 1.10-9.11 and OR, 4.62; 95%CI, 1.54-13.85, respectively). In conclusion, the rate of significant lesions among women referred for colposcopy after AGC smears is considerably high. Low education and smear subtypes appear independently associated with a higher risk of significant lesions.
Atypical glandular cell;cervical smear;histology;predictor
- Apgar BS, Zoschnick L, Wright TC Jr (2003). The 2001 Bethesda System terminology. Am Fam Physician, 68, 1992-8.
- Aue-Aungkul A, Punyawatanasin S, Natprathan A, et al (2011). “See and treat” approach is appropriate in women with highgrade lesions on either cervical cytology or colposcopy. Asian Pac J Cancer Prev, 12, 1723-6.
- Ben-Shlomo Y, White IR, Marmot M (1996). Does the variation in the socioeconomic characteristics of an area affect mortality? BMJ, 312, 1013-4. https://doi.org/10.1136/bmj.312.7037.1013
- Chatchotikawong U, Ruengkhachorn I,Laiwejpithaya S (2012). Factors predicting pathologic significance among women with atypical glandular cells on liquid-based cytology. Int J Gynaecol Obstet, 119, 30-4. https://doi.org/10.1016/j.ijgo.2012.05.027
- Falconer H, Yin L, Gronberg H, et al (2015). Ovarian cancer risk after salpingectomy: a nationwide population-based study. J Natl Cancer Inst, 107, 410. https://doi.org/10.1093/jnci/dju410
- Falkingham J (2003). Inequality and changes in women's use of maternal health-care services in Tajikistan. Stud Fam Plann, 34, 32-43. https://doi.org/10.1111/j.1728-4465.2003.00032.x
- Kietpeerakool C, Tangjitgamol S, Srisomboon J (2014). Histopathological outcomes of women with abnormal cervical cytology: a review of literature in Thailand. Asian Pac J Cancer Prev, 15, 6489-94. https://doi.org/10.7314/APJCP.2014.15.16.6489
- Massad LS, Einstein MH, Huh WK, et al (2013). 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. Obstet Gynecol, 121, 829-46. https://doi.org/10.1097/AOG.0b013e3182883a34
- Moore MA, Attasara P, Khuhaprema T, et al (2010). Cancer epidemiology in mainland South-East Asia - past, present and future. Asian Pac J Cancer Prev, 11, 67-80.
- Paengchit K, Kietpeerakool C, Lalitwongsa S(2014). Prevalence and genotype distribution of HPV among women attending a cervical cancer screening mobile unit in Lampang, Thailand. Asian Pac J Cancer Prev, 15, 6151-4. https://doi.org/10.7314/APJCP.2014.15.15.6151
- Paengchit K, Kietpeerakool C, Wangchai W, et al (2014). Cervical pathology in cytology-negative/HPV-positive women: results from Lampang Cancer Hospital, Thailand. Asian Pac J Cancer Prev, 15, 7951-4. https://doi.org/10.7314/APJCP.2014.15.18.7951
- Sawangsang P, Sae-Teng C, Suprasert P, et al (2011). Clinical significance of atypical glandular cells on Pap smears: experience from a region with a high incidence of cervical cancer. J Obstet Gynaecol Res, 37, 496-500. https://doi.org/10.1111/j.1447-0756.2010.01387.x
- Schellenberg JA, Victora CG, Mushi A, et al (2003). Inequities among the very poor: health care for children in rural southern Tanzania. Lancet, 361, 561-6. https://doi.org/10.1016/S0140-6736(03)12515-9
- Supho B, Supoken A, Kleebkaew P, et al (2014). Cervical pathology in high-risk human papillomavirus- positive, cytologically normal women. Asian Pac J Cancer Prev, 15, 7977-80. https://doi.org/10.7314/APJCP.2014.15.18.7977
- Veugelers PJ,Yip AM (2003). Socioeconomic disparities in health care use: Does universal coverage reduce inequalities in health? J Epidemiol Community Health, 57, 424-8. https://doi.org/10.1136/jech.57.6.424
- Westin MC, Derchain SF, Rabelo-Santos SH, et al (2008). Atypical glandular cells and adenocarcinoma in situ according to the Bethesda 2001 classification: cytohistological correlation and clinical implications. Eur J Obstet Gynecol Reprod Biol, 139, 79-85. https://doi.org/10.1016/j.ejogrb.2007.08.017
- Zhao C, Florea A, Onisko A, et al (2009). Histologic follow-up results in 662 patients with Pap test findings of atypical glandular cells: results from a large academic womens hospital laboratory employing sensitive screening methods. Gynecol Oncol, 114, 383-9. https://doi.org/10.1016/j.ygyno.2009.05.019