Ss. Raab et al., ATYPICAL GLANDULAR CELLS OF UNDETERMINED SIGNIFICANCE - DIAGNOSTIC-ACCURACY AND INTEROBSERVER VARIABILITY USING SELECT CYTOLOGIC CRITERIA, American journal of clinical pathology, 107(3), 1997, pp. 299-307
Histologic follow-up of patients with the Bethesda system cervical-vag
inal diagnosis of atypical glandular cells of undetermined significanc
e (AGUS), ''favor endocervical origin'', or ''not otherwise specified'
' (NOS) shows a high percentage of clinically significant (neoplastic
or preneoplastic) lesions. Using the criteria of atypical single cells
, irregular nuclear membranes, and decreased cytoplasm, eight observer
s retrospectively reclassified 88 AGUS, ''favor endocervical'', or NOS
smears using a probabilistic scheme. Follow-up showed 46 clinically s
ignificant and 42 benign lesions. The mean accuracy for all observers
and the experienced observers was 65% and 72%, respectively. For the e
xperienced observers, the mean specificity of a ''favor clinically sig
nificant'' category was 72%; the mean sensitivity of a ''favor benign'
' category was 90%. For the less experienced observers, subclassificat
ion had poor predictive value. We conclude that experienced observers
may use specific criteria to correctly subclassify AGUS lesions, and t
his may aid in patient management.