Atypical Glandular Cells of Undetermind Significances (AGUS) ; Histopathologic Results and the Significance of the HPV DNA Detection

Kim, Chan Joo; Park, Tae Chul; Park, Jong Sup; Lee, Jun Mo; Kim, Seung Jo; NamKoong, Sung Eun

Abstract

OBJECTIVES
AGUS often reflects an immediate cervical cancer precursor such as a HSIL mimicking an endocervical glandular lesion. In this study, we attempted to assess the clinical significance of a cytologic diagnosis of atypical glandular cells of undetermined significance (AGUS) and determine the usefulness of the human papillomavirus (HPV) DNA testing as the triage strategies in evaluating AGUS.
METHODS
Between 1994 and 1998, 67,730 Papanicolaou smears were evaluated at Kangnam and Uijongbu St Mary's Hospital. There were 87 (0.13%) cases of AGUS smears during that time. Colposcopy was performed on all women, and HPV DNA testing was performed on 11 persons.
RESULTS
Mean age of these patients was 45.8 years. Histologic diagnosis of AGUS were kolocytosis and CIN-I in 6 (6.9%), CIS in one, endometrial hyperplasia in 2 (2.3%), endometrial adenocarcinoma in 7 (8.0%), cervical adenocarcinoma in 14 (16.1%) and cervical squamous cell carcinoma in 2 (2.3%) cases. Endometriosis was 8.9% under 46 years old and none in over 46. CIN was 8.9% and 7.2%, respectively. Cervical adenocarcinoma was 6.7% under 46 and 19.1% over 46. Endometrial cancer was 4.4% and 11.9%, respectively. The risk of cervical cancer and endometrial cancer was high in the AGUS with CONCLUSIONS
A significant proportion of women with a cytologic diagnosis of AGUS have abnormal histopathology. Use of HPV DNA testing in patients with AGUS may provide improvements in the management of woman with AGUS.