[383] Histologic Follow-Up for Atypical Endocervical Cells

Bryan L Janssen, Michael J Thrall. Methodist Hospital, Houston, TX

Background: In previous literature on atypical glandular cells, using conventional and non-imaged liquid-based Papanicoalou (Pap) tests, squamous dysplasia was about twice as likely to be found on follow-up as glandular neoplasia (Davey et al. APLM 2000). We have examined the performance of atypical endocervical cell categories in our experience with imager-aided liquid-based screening.
Design: Cases from the categories of atypical endocervical cells (AECC), atypical endocervical cells favor neoplastic (FN), and atypical endocervical cells favor adenocarcinoma in situ (AIS) were collected. These were correlated with subsequent histologic follow-up. Cases were stratified into two patient groups: a dysplasia clinic and the general population. The two-tailed Fischer exact test was used to calculate p-values.
Results: Over a six year period, 120 cases were identified with tissue follow-up available in 76 (63.3%).

 AECCAISFNTotal
 N=86N=15N=19N=120
Available tissue follow-up49 (56.9%)10 (66.7%)17 (89.5%)76 (63.3%)
Average age (range)40 (19-66)36 (28-58)34 (21-67)37.5 (19-67)
HGSIL (CIN 2/3)8†5‡6†19 (25.0%)
LGSIL (HPV/CIN I)7∗,∗∗029 (11.8%)
AIS5∗,†4‡4†13 (16.1%)
Cervical adenocarcinoma1102 (2.6%)
Endometrial adenocarcinoma1∗∗012 (2.6%)
Total1971238 (50%)
∗1 with AIS and LGSIL    
∗∗1 with enodometrial adenocarcinoma and LGSIL    
†1 with AIS and HGSIL    
‡3 with AIS and HGSIL    


Dysplasia clinic patients were more likely to have interpretations of FN and AIS versus AECC (17/34) when compared to other patients (17/86) and were also more likely to have positive findings on histologic follow-up (20/34 versus 17/86, p=0.0089). When looking at all patients, AIS and FN were more likely to show significant findings on histologic follow up than AECC (p-value=0.016). However, AIS and FN had similar follow-up positive rates (p-value=1.0).
Conclusions: Relative to prior studies, we had a much higher proportion of the follow-up biopsies that showed glandular neoplasia. Our data comes from a context of imager-assisted liquid-based screening. One explanation is that this technology has helped us to more accurately identify squamous lesions, accounting for our relatively high yield. These categories performed better in a high-risk population than in the general population. AIS and FN performed similarly to each other, and much better than AECC.
Category: Cytopathology

Monday, March 4, 2013 1:00 PM

Poster Session II # 95, Monday Afternoon

 

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