COLPOSCOPY IN PATIENTS WITH ATYPICAL GLANDULAR CELLS ON PAP SMEARS

The aim of this study was to review the risk of preneoplastic cervical lesions or invasive gynecologic cancer in patients with atypical glandular cells (AGC) on Papanicolaou smear and to establish the place of colposcopy in the management of these patients. Material and methods: We have analyzed all cases with ACG who attended our colposcopy clinic between 2001-2014. All cases were followed for a period of at least 36 months after the diagnosis of AGC on Pap smear. Medical records were reviewed to determine the clinical data, colposcopy findings and histology results. Results: We have analyzed 78 women with AGC on Pap smear. The age of the patients was 41+/-12.3 years old. Normal colposcopy, minor colposcopy changes, major colposcopy changes and suspicion of invasion were encountered in 44 cases (56.4%), 8 cases (10.2%), 12 cases (15.4%), and respectively, 1 case (1.3%) case. The colposcopy was not satisfactory (transformation zone type III) in 13 cases (16.6%). Histology was abnormal in 25 cases (32%) as follow: invasive cancer 5 cases (7.1%), adenocarcinoma in situ in 2 cases (2.6%), high-grade cervical lesion 8 cases (10.6%) and low-grade cervical lesion 10 cases (12.8%). Conclusions: The ACG diagnosis needs new strategies in order to reduce the overtreatment but not to increase the false negative results. Colposcopy is useful in cases with associated squamous cervical lesions, but new diagnostic tools are mandatory for a better management. A possible one is represented by Human Papilloma Virus test, but the place of this test should be clarified by further studies.