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CC BY 4.0 · Rev Bras Ginecol Obstet 2022; 44(05): 483-488
DOI: 10.1055/s-0042-1742318
Original Article
Gynecological Oncology

Preventing Uterine Cervix Cancer: The Clinical Meaning of Atypical Glandular Cells

Prevenção do câncer do colo uterino: Significado clínico das células glandulares atípicas
Gutemberg Almeida 
1   Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
,
Jorge Eduardo Sainz 
1   Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
,
Renata Fonseca 
1   Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
,
Neil Chaves 
1   Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
,
Katia Silveira Silva 
2   Instituto Fernandes Figueira, Rio de Janeiro, RJ, Brazil
,
Julio Nunes 
3   Department of Psychiatry and Behavior Sciences, Stanford University, Stanford, CA, United States
,
Yara Furtado 
1   Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
4   Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Abstract

Objective To determine the prevalence of the atypical glandular cells (AGCs) cytology and to analyze its clinical significance in different age ranges.

Methods Retrospective observational study using computerized data from the Brazilian National Cancer Institute, including women screened between January 2002 and December 2008. The women included were those with an AGC result who were properly followed-up with colposcopy and a second cytology.

Results A total of 132,147 cytopathological exams were performed during the study period. Five-hundred and thirty-three (0.4%) women with AGC cytology were identified and, of these, 69.41% (370/533) were properly referred for colposcopy and a new cytology. Most of the women (79.2%) with a 1st or 2nd AGC cytology were between the ages of 25 and 54 years. The 2nd cytology demonstrated 67.6% (250/370) of normality, 24.5% (91/370) of squamous atypia, and 6.2% (23/370) of AGC, 0.8% (3/370) adenocarcinoma in situ and 0.8% (3/370) adenocarcinoma invasor. On biopsy of the women with a second AGC cytology, 43.4% (10/23) had normal histology, 43.4% (10/23) had squamous lesions, 8.7% (2/23) had invasive adenocarcinoma, and 1.2% (1/23) had an inconclusive report. All of the women with high-grade squamous intraepithelial lesion (HSIL) or invasive adenocarcinoma (respectively 5 and 2 patients), after a 2nd AGC cytology were 25 years old or older.

Conclusion The prevalence of the AGC cytology was low in the studied population. Most of the AGC cytology cases occurred in adult women between the ages of 25 and 54. Although most of the patients had normal histology after follow-up, several of them presented with squamous intraepithelial lesions or invasive adenocarcinoma.

Resumo

Objetivo Determinar a prevalência de citologia com laudo de células glandulares atípicas (AGCs, na sigla em inglês) e analisar a significância clínica nas diferentes faixas etárias

Métodos Estudo observacional retrospectivo, usando os dados arquivados no sistema do Instituto Nacional de Câncer no Brasil, que incluiu mulheres rastreadas entre janeiro de 2002 a dezembro de 2008. As mulheres incluídas tinham citologia com resultado de AGCs, que foram acompanhadas com colposcopia e nova citologia

Resultados Um total de132,147 exames citopatológicos foram incluídos durante o período de estudo. Quinhentas e trinta e três mulheres com citologia de AGC foram identificadas e destas, 69.41% (370) foram encaminhadas para colposcopia e nova citologia. A prevalência de citologia de AGC na população estudada foi 0.4%. A maioria das mulheres (79.22%) com resultado citológico de AGC tinham idade entre 25 e 54 anos. A segunda citologia demonstrou 67.56% (250/370) de normalidade, 24.5% (91/370) de atipias escamosas, e 6.2% (23/370) de AGC. Na biopsia das mulheres com a 2ª citologia de AGC, 43.4% (10/23) tinham histologia normal, 43.4% (10/23) tinha lesões escamosas, 8.7% (2/23) tinha adenocarcinoma invasor e 1.2% (1/23) tinha laudo inconclusivo. Todas as mulheres com lesões intraepiteliais escamosas de alto grau (HSIL, na sigla em inglês) ou adenocarcinoma invasor (respectivamente 5 e 2 pacientes), após a 2ª citologia com AGC, tinham 25 anos de idade ou mais.

Conclusão A prevalência de citologia com AGC foi baixa na população estudada. Muitos casos de citologia com AGC apareceram em mulheres adultas, entre 25 e 54 anos de idade. Embora a maioria das pacientes tiveram histologia normal após seguimento, várias apresentaram lesões intraepiteliais escamosas ou glandulares invasoras.

Keywords

AGC - atypical glandular cells - glandular cervical neoplasia - Bethesda system - cervical cancer screening - cytology

Palavras-chave

AGC - células glandulares atípicas - neoplasia glandular cervical - sistema Bethesda - rastreio do câncer do colo uterino - citologia

Contributors

Gutemberg Almeida - conceptualization, methodology, investigation, writing (Original Draft). Jorge Wduardo Sainz - supervision, tesources, data surveys. Renata Fonseca - writing (ooriginal draft), writing (review and editing). Neil Chaves—investigation, data curation. Katia Silva - statistical calculation, tables making. Julio C Nunes - writing (review and editing), visualization. Yara Furtado - conceptualization, investigation, writing (Original Draft).




Publication History

Received: 11 June 2021

Accepted: 11 November 2021

Article published online:
09 February 2022

© 2022. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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