Significance of atypical glandular cells of undetermined significance on ThinPrep Papanicolaou smears

Objective. The aim of this study was to assess the incidence and risk facto rs predictive of significant histopathologic findings among women with atyp ical glandular cells of undetermined significance (AGCUS) on ThinPrep Papan icolaou smears. Methods. ThinPrep smears with AGCUS obtained between 1997 and 1999 were rev iewed. Patients' charts were reviewed and patients' characteristics, follow -up information, and colposcopy and biopsy results were recorded. Pathologi c slides were reviewed. The demographic features of women with favor reacti ve smears were compared with those with favor neoplasia and risk factors pr edictive of significant histopathologic findings (high-grade squamous intra epithelial lesion, endometrial hyperplasia, and cervical or endometrial can cers) were calculated. Results. The rate of diagnosis of AGCUS was 0.65%. Eighty-four patients wit h follow-up information were identified. The demographic features of women with smears favor neoplasia (n = 43) were similar to those with smears favo r reactive (n = 41). The rates of incidence of any dysplasia or cancer and significant histopathologic findings were 32.1 and 22.6%, respectively, and were higher among women with smears favor neoplasia than among women with smears favor reactive (41.9% versus 22.0%, P = 0.051, and 34.9% versus 9.8% , P = 0.006, respectively). The subtype of cytology was the only factor tha t predicted significant histopathologic findings (odds ratio = 5.0, 95% con fidence interval 1.6, 15.6, P < 0.010). Conclusions. In women with AGCUS on ThinPrep smears, significant histopatho logic findings were found in 34.9% versus 9.8%, depending on the subtype of the smear (favor neoplasia vs reactive). Further studies are needed to val idate the cytologic criteria for subtyping AGCUS smears and base management of women with AGCUS cytology on the subtype of the smear. (C) 2000 Academi c Press.