Atypical glandular cells and predictive features of malignancy in Pap smears: A retrospective monocentric study

IF 1.2 4区医学 Q4 CELL BIOLOGY Cytopathology Pub Date : 2024-04-30 DOI:10.1111/cyt.13383

Federica Cianfrini, Antonio d'Amati, Damiano Arciuolo, Antonio Travaglino, Nicoletta D'Alessandris, Giulia Scaglione, Michele Valente, Belen Padial Urtueta, Francesca Addante, Nadine Narducci, Giuseppe Angelico, Alessia Piermattei, Antonino Mulè, Angela Santoro, Esther Diana Rossi, Gian Franco Zannoni

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Abstract

Objective

The introduction of cytological screening with the Papanicolau smear significantly reduced cervical cancer mortality. However, Pap smear examination can be challenging, being based on the observer ability to decode different cytological and architectural features. This study aims to evaluate the malignancy rate of AGC (atypical glandular cells) category, investigating the relationships between cytological and histological diagnosis.

Methods

Eighty-nine patients, diagnosed as AGC at cytological evaluation and followed up with biopsy or surgical procedure at Policlinico Gemelli Hospital, Rome, Italy, were included in the study. The cytopathological architectural (feathering, rosette formation, overlapping, loss of polarity, papillary formation, three-dimensional formation) and nuclear (N/C ratio, nuclear enlargement and hyperchromasia, mitoses, nuclei irregularity, evident nucleoli) features of AGC were evaluated. Statistical analyses were performed to assess cyto-histological correlation and determine the relevance of architectural and nuclear features in the diagnosis of malignancy.

Results

Of the 89 AGC patients, 48 cases (53.93%) were diagnosed as AGC-NOS and 41 (46.07%) were diagnosed as AGC-FN, according to the Bethesda classification system. The follow-up biopsies or surgical resections revealed malignancy in 46 patients (51.69%). The rates of malignancy for AGC-NOS and AGC-FN were 35.41% and 70.73% respectively. Furthermore, analysing cytopathological features, we found that both architectural and nuclear criteria were statistically significant (p < 0.05). Only overlapping, nuclear irregularity and increased N/C ratio were not found to be statistically significant for detecting malignancy.

Conclusions

Cytological diagnosis of glandular lesions remains a valid tool, when appropriate clinical correlation and expert evaluation are available.

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巴氏涂片中的非典型腺细胞和恶性肿瘤的预测特征：回顾性单中心研究

目的采用巴氏涂片进行细胞学筛查，大大降低了宫颈癌的死亡率。然而，巴氏涂片检查是一项具有挑战性的工作，它取决于观察者对不同细胞学和结构特征的解读能力。本研究旨在评估 AGC（非典型腺细胞）类别的恶变率，调查细胞学诊断和组织学诊断之间的关系。研究纳入了意大利罗马 Policlinico Gemelli 医院经细胞学评估诊断为 AGC 并进行活检或手术随访的 89 例患者。研究人员对 AGC 的细胞病理学结构（羽化、莲座状形成、重叠、极性丧失、乳头状形成、三维形成）和细胞核（N/C 比值、核增大和色素沉着、有丝分裂、核不规则、核仁明显）特征进行了评估。结果根据贝塞斯达分类系统，89 例 AGC 患者中有 48 例（53.93%）被诊断为 AGC-NOS，41 例（46.07%）被诊断为 AGC-FN。随访活检或手术切除结果显示，46 例患者（51.69%）出现恶性肿瘤。AGC-NOS和AGC-FN的恶变率分别为35.41%和70.73%。此外，在分析细胞病理学特征时，我们发现建筑学和核标准均有统计学意义（P < 0.05）。结论如果有适当的临床相关性和专家评估，腺体病变的细胞学诊断仍然是一种有效的工具。

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来源期刊

Cytopathology 生物-病理学

CiteScore

2.30

自引率

15.40%

发文量

107

审稿时长

6-12 weeks

期刊介绍： The aim of Cytopathology is to publish articles relating to those aspects of cytology which will increase our knowledge and understanding of the aetiology, diagnosis and management of human disease. It contains original articles and critical reviews on all aspects of clinical cytology in its broadest sense, including: gynaecological and non-gynaecological cytology; fine needle aspiration and screening strategy. Cytopathology welcomes papers and articles on: ultrastructural, histochemical and immunocytochemical studies of the cell; quantitative cytology and DNA hybridization as applied to cytological material.