TY - JOUR
T1 - Atypical glandular cells of undetermined significance (AGUS)
T2 - Cytopathologic features, histopathologic results, and human papillomavirus DNA detection
AU - Ronnett, Brigitte M.
AU - Manos, M. Michele
AU - Ransley, Janice E.
AU - Feherman, Barbara J.
AU - Kinney, Walter K.
AU - Hurley, Leo B.
AU - Ngai, Jen Shieh
AU - Kurman, Robert J.
AU - Sherman, Mark E.
N1 - Funding Information:
From the Departments of Pattiology and Gynecology arrd Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, MD; and The Northern :Califorr/ia Permanente Medical Group, Oakland, CA. Accepted for publication February 23, 1999. Supported by a grant from the Kaiser Permanente Innovations Program (to MMM, WKK)and by grants, technical support, reagents, supplies, and equipment from Cytyc Corporation and Digene Corporation (to MMM). Address correspondence and reprint, requests to Mark E. Sherman, MD, The Johns Hopkins Medical Institutions, Ross Research Bldg Rm 659, 720 Rutland Ave, Baltimore, MD 21205. Copyright © 1999 by W.B. Saunders Company 0046-8177/99/3007-0013510.00/0 negative in 105 (77%), squamons or glandular atypia in four (3%), low-grade SIL (LSIL) in nine (7%), HSIL in 12 (9%), MS in five (4%, including two with concurrent HSIL), and endometrial carcinoma in one (1%). HPV testing identified 11 (92%) of 12 women with histologically confirmed HSIL and all five with AIS (100%). A hlgh-grade intraepithelial lesion or carcinoma is detected in approximately 14% of women with community-based diagnoses of AGUS who are referred for immediate evaluation. Use of refined cytological criteria and HPV DNA testing may permit improved management of women with AGUS. HUM PATHOL 30:816-825. Copyright © 1999 byW.B. Saunders Company Keyw ords: atypical glandular cells Of undetermined significance , AGUS, Pap smear, human papiUomavirus, cervix, cytology, The Bethesda System.
PY - 1999
Y1 - 1999
N2 - We intensively reviewed 137 smears initially classified as atypical glandular cells of undetermined significance (AGUS) to refine cytological criteria for evaluating these cases, evaluate histological outcomes, and assess the value of human papillomavirus (HPV) DNA testing in management. Consenting, nonpregnant study participants were identified from a cohort of 46,009 women receiving routine Pap smear screening in a managed care setting. Colposcopy was performed on all women, and at least one histological sample was obtained from each. Review diagnoses were assigned to smears and biopsy specimens by two separate panels of pathologists. DNA testing for cancer- associated HPV types was performed on rinses of cytological samplers after a smear and thin-layer slide had been made. On review, 47 (34%) smears were reclassified as negative, 44 (32%) as AGUS, 30 (22%) as atypical squamous cells of undetermined significance (ASCUS), and 16 (12%) as squamous intraepithelial lesions (SIL). The 19 smears interpreted as high-grade intraepithelial lesions on review included 13 high-grade SIL (HSIL), two HSIL with AGUS, favor neoplastic (endocervical adenocarcinoma in situ [AIS]), and four AGUS, favor neoplastic (AIS). Review histological diagnoses were negative in 105 (77%), squamous or glandular atypia in four (3%), low-grade SIL (LSIL) in nine (7%), HSIL in 12 (9%), AIS in five (4%, including two with concurrent HSIL), and endometrial carcinoma in one (1%). HPV testing identified 11 (92%) of 12 women with histologically confirmed HSIL and all five with AIS (100%). A high-grade intraepithelial lesion or carcinoma is detected in approximately 14% of women with community-based diagnoses of AGUS who are referred for immediate evaluation. Use of refined cytological criteria and HPV DNA testing may permit improved management of women with AGUS.
AB - We intensively reviewed 137 smears initially classified as atypical glandular cells of undetermined significance (AGUS) to refine cytological criteria for evaluating these cases, evaluate histological outcomes, and assess the value of human papillomavirus (HPV) DNA testing in management. Consenting, nonpregnant study participants were identified from a cohort of 46,009 women receiving routine Pap smear screening in a managed care setting. Colposcopy was performed on all women, and at least one histological sample was obtained from each. Review diagnoses were assigned to smears and biopsy specimens by two separate panels of pathologists. DNA testing for cancer- associated HPV types was performed on rinses of cytological samplers after a smear and thin-layer slide had been made. On review, 47 (34%) smears were reclassified as negative, 44 (32%) as AGUS, 30 (22%) as atypical squamous cells of undetermined significance (ASCUS), and 16 (12%) as squamous intraepithelial lesions (SIL). The 19 smears interpreted as high-grade intraepithelial lesions on review included 13 high-grade SIL (HSIL), two HSIL with AGUS, favor neoplastic (endocervical adenocarcinoma in situ [AIS]), and four AGUS, favor neoplastic (AIS). Review histological diagnoses were negative in 105 (77%), squamous or glandular atypia in four (3%), low-grade SIL (LSIL) in nine (7%), HSIL in 12 (9%), AIS in five (4%, including two with concurrent HSIL), and endometrial carcinoma in one (1%). HPV testing identified 11 (92%) of 12 women with histologically confirmed HSIL and all five with AIS (100%). A high-grade intraepithelial lesion or carcinoma is detected in approximately 14% of women with community-based diagnoses of AGUS who are referred for immediate evaluation. Use of refined cytological criteria and HPV DNA testing may permit improved management of women with AGUS.
KW - AGUS
KW - Atypical glandular cells of undetermined significance
KW - Cervix
KW - Cytology
KW - Human papillomavirus
KW - Pap smear
KW - The Bethesda System
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UR - http://www.scopus.com/inward/citedby.url?scp=0032783712&partnerID=8YFLogxK
U2 - 10.1016/S0046-8177(99)90143-0
DO - 10.1016/S0046-8177(99)90143-0
M3 - Article
C2 - 10414501
AN - SCOPUS:0032783712
SN - 0046-8177
VL - 30
SP - 816
EP - 825
JO - Human Pathology
JF - Human Pathology
IS - 7
ER -