Journal of Pathology and Translational Medicine

Original Articles

Diagnostic distribution and pitfalls of glandular abnormalities in cervical cytology: a 25-year single-center study: Jung-A Sung, Ilias P. Nikas, Haeryoung Kim, Han Suk Ryu, Cheol Lee; J Pathol Transl Med. 2022;56(6):354-360. Published online November 9, 2022; DOI: https://doi.org/10.4132/jptm.2022.09.05

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Background
Detection of glandular abnormalities in Papanicolaou (Pap) tests is challenging. This study aimed to review our institute’s experience interpreting such abnormalities, assess cytohistologic concordance, and identify cytomorphologic features associated with malignancy in follow-up histology.
Methods
Patients with cytologically-detected glandular lesions identified in our pathology records from 1995 to 2020 were included in this study.
Results
Of the 683,197 Pap tests performed, 985 (0.144%) exhibited glandular abnormalities, 657 of which had tissue follow-up available. One hundred eighty-eight cases were cytologically interpreted as adenocarcinoma and histologically diagnosed as malignant tumors of various origins. There were 213 cases reported as atypical glandular cells (AGC) and nine cases as adenocarcinoma in cytology, yet they were found to be benign in follow-up histology. In addition, 48 cases diagnosed with AGC and six with adenocarcinoma cytology were found to have cervical squamous lesions in follow-up histology, including four squamous cell carcinomas. Among the cytomorphological features examined, nuclear membrane irregularity, three-dimensional clusters, single-cell pattern, and presence of mitoses were associated with malignant histology in follow-up.
Conclusions
This study showed our institute’s experience detecting glandular abnormalities in cervical cytology over a 25-year period, revealing the difficulty of this task. Nonetheless, the present study indicates that several cytological findings such as membrane irregularity, three-dimensional clusters, single-cell pattern, and evidence of proliferation could help distinguishing malignancy from a benign lesion.

Citations

Citations to this article as recorded by

Analysis of atypical glandular cells in ThinPrep Pap smear and follow-up histopathology
Tengfei Wang, Yinan Hua, Lina Liu, Bing Leng
Baylor University Medical Center Proceedings.2024; 37(3): 403. CrossRef

Comparison of papanicolaou smear and human papillomavirus (HPV) test as cervical screening tools: can we rely on HPV test alone as a screening method? An 11-year retrospective experience at a single institution: Myunghee Kang, Seung Yeon Ha, Hyun Yee Cho, Dong Hae Chung, Na Rae Kim, Jungsuk An, Sangho Lee, Jae Yeon Seok, Juhyeon Jeong; J Pathol Transl Med. 2020;54(1):112-118. Published online January 15, 2020; DOI: https://doi.org/10.4132/jptm.2019.11.29

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Abstract PDF

Background
The decrease in incidence of cervical dysplasia and carcinoma has not been as dramatic as expected with the development of improved research tools and test methods. The human papillomavirus (HPV) test alone has been suggested for screening in some countries. The National Cancer Screening Project in Korea has applied Papanicolaou smears (Pap smears) as the screening method for cervical dysplasia and carcinoma. We evaluated the value of Pap smear and HPV testing as diagnostic screening tools in a single institution.
Methods
Patients co-tested with HPV test and Pap smear simultaneously or within one month of each other were included in this study. Patients with only punch biopsy results were excluded because of sampling errors. A total of 999 cases were included, and the collected reports encompassed results of smear cytology, HPV subtypes, and histologic examinations.
Results
Sensitivity and specificity of detecting high-grade squamous intraepithelial lesion (HSIL) and squamous cell carcinoma (SCC) were higher for Pap smears than for HPV tests (sensitivity, 97.14%; specificity, 85.58% for Pap smears; sensitivity, 88.32%; specificity, 54.92% for HPV tests). HPV tests and Pap smears did not differ greatly in detection of low-grade squamous intraepithelial lesion (85.35% for HPV test, 80.31% for Pap smears). When atypical glandular cells were noted on Pap smears, the likelihood for histologic diagnosis of adenocarcinoma following Pap smear was higher than that of high-risk HPV test results (18.8 and 1.53, respectively).
Conclusions
Pap smears were more useful than HPV tests in the diagnosis of HSIL, SCC, and glandular lesions.

Citations

Citations to this article as recorded by

Challenges in the diagmosis of cervical pathologies
D. Y. Chernov, O. A. Tikhonovskaya, S. V. Logvinov, I. A. Petrov, Y. S. Yuriev, A. A. Zhdankina, A. V. Gerasimov, I. V. Zingalyuk, G. A. Mikheenko
Bulletin of Siberian Medicine.2024; 22(4): 201. CrossRef
Selection of endogenous control and identification of significant microRNA deregulations in cervical cancer
T. Stverakova, I. Baranova, P. Mikyskova, B. Gajdosova, H. Vosmikova, J. Laco, V. Palicka, H. Parova
Frontiers in Oncology.2023;[Epub] CrossRef
Attitudes towards prevention of cervical cancer and early diagnosis among female academicians
Nurhan Doğan, Gamze Fışkın
Journal of Obstetrics and Gynaecology Research.2022; 48(6): 1433. CrossRef
Role of Self-Sampling for Cervical Cancer Screening: Diagnostic Test Properties of Three Tests for the Diagnosis of HPV in Rural Communities of Cuenca, Ecuador
Bernardo Vega Crespo, Vivian Alejandra Neira, José Ortíz Segarra, Ruth Maldonado Rengel, Diana López, María Paz Orellana, Andrea Gómez, María José Vicuña, Jorge Mejía, Ina Benoy, Tesifón Parrón Carreño, Veronique Verhoeven
International Journal of Environmental Research and Public Health.2022; 19(8): 4619. CrossRef
Utility of Scoring System for Screening and Early Warning of Cervical Cancer Based on Big Data Analysis
Dan Hou, Binjie Yang, Yangdan Li, Ming Sun
Frontiers in Public Health.2022;[Epub] CrossRef
Evaluation of Urine and Vaginal Self-Sampling versus Clinician-Based Sampling for Cervical Cancer Screening: A Field Comparison of the Acceptability of Three Sampling Tests in a Rural Community of Cuenca, Ecuador
Bernardo Vega Crespo, Vivian Alejandra Neira, José Ortíz S, Ruth Maldonado-Rengel, Diana López, Andrea Gómez, María José Vicuña, Jorge Mejía, Ina Benoy, Tesifón Parrón Carreño, Veronique Verhoeven
Healthcare.2022; 10(9): 1614. CrossRef
Diagnostic distribution and pitfalls of glandular abnormalities in cervical cytology: a 25-year single-center study
Jung-A Sung, Ilias P. Nikas, Haeryoung Kim, Han Suk Ryu, Cheol Lee
Journal of Pathology and Translational Medicine.2022; 56(6): 354. CrossRef
Comparison of Learning Transfer Using Simulation Problem-Based Learning and Demonstration: An Application of Papanicolaou Smear Nursing Education
Jeongim Lee, Hae Kyoung Son
International Journal of Environmental Research and Public Health.2021; 18(4): 1765. CrossRef
Investigating host-virus interaction mechanism and phylogenetic analysis of viral proteins involved in the pathogenesis
Ahmad Abu Turab Naqvi, Farah Anjum, Alaa Shafie, Sufian Badar, Abdelbaset Mohamed Elasbali, Dharmendra Kumar Yadav, Md. Imtaiyaz Hassan, Timir Tripathi
PLOS ONE.2021; 16(12): e0261497. CrossRef
Utility of Human Papillomavirus Testing for Cervical Cancer Screening in Korea
Mee-seon Kim, Eun Hee Lee, Moon-il Park, Jae Seok Lee, Kisu Kim, Mee Sook Roh, Hyoun Wook Lee
International Journal of Environmental Research and Public Health.2020; 17(5): 1726. CrossRef

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