Clinicopathological significance of atypical glandular cells in cervical liquid-based cytology test
Objective:Despite the widespread adoption of cervical screening,the incidence of cervical adenocarcinoma continues to rise.This study aims to analyze atypical glandular cells(AGC)detected in thinprep cytology tests(TCT)and explore their clinical significance.Methods:A total of 87 AGC cases were collected for histopathological diagnosis and human papilloma virus(HPV)testing to investigate the relationship between AGC and histological diagnoses,HPV infection,and other clinicopathological characteristics.Results:Among the 87 AGC cases,23 cases(26.44％)were classified as atypical glandular cells-not otherwise specified(AGC-NOS),28 cases(32.18％)as atypical endocervical cells(AEC),13 cases(14.94％)as atypical endometrial cells(AMC),and 23 cases(26.44％)as atypical glandular cells-favor neoplastic(AGC-FN).Histopathological diagnosis revealed 19 cases(21.8％)of benign lesions,34 cases(39.1％)of epithelial intraepithelial lesions,and 34 cases(39.1％)of malignant lesions.The lesions involved the cervix,endometrium,ovary,and metastatic cervical adenocarcinoma of gastrointestinal origin.Immunohistochemical staining of liquid-based cytology slides for cyclin-dependent kinase inhibitor 2A(p16)and Ki-67 cell proliferation index was helpful in AGC diagnosis.Cervical lesions were more strongly associated with HPV infection than endometrial lesions(P<0.01).Patients aged≥40 years had a higher prevalence of cervical glandular epithelial lesions than squamous epithelial lesions(P<0.05).Additionally,endometrial lesions were significantly more common than cervical lesions in patients aged≥40 years(P<0.01).Most invasive lesions in AGC cases were diagnosed at stage Ⅰ or Ⅱ(79.3％).Conclusion:AGC is an important indicator for cervical epithelial and endometrial lesions.The combination of HPV testing,immunohistochemical markers,and patient age provides valuable guidance for clinical diagnosis.
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