Factors predicting pathologic significance among women with atypical glandular cells on liquid-based cytology

Objective: To determine incidence, originating organ, and factors predicting significant histopathology (premalignant and malignant lesions) among women with atypical glandular cells (AGCs) on liquid-based cytology (LBC). Methods: In a retrospective study at Siriraj Hospital, Bangkok, Thailand, clinical and histologic data were reviewed for women with AGCs who underwent appropriate examinations from January 2007 to December 2010. Results: There were 284 women with AGC cytology (mean age, 51.2 years). The incidence of significant pathology and invasive cancer was 43.3% and 34.5%, respectively. The most common malignant organ was the uterus (64/123, 52%). Predictors of serious pathology were AGC favor neoplasia (AGC-FN) endocervical (odds ratio [OR], 5.64; 95% confidence interval [CI], 1.62-19.57), AGC-FN endometrial (OR, 4.11; 95% CI, 1.27-13.32), AGC-FN glandular (OR, 8.23; 95% CI, 2.02-33.49) subtypes, and bleeding (OR, 2.88; 95% CI, 1.47-5.65). Combining patient age and AGC subtype, there were no serious cervical lesions among women aged 50 years or younger with AGC-FN glandular subtype, or serious non-cervical neoplasia among women aged 50 years or younger with AGC not otherwise specified (AGC-NOS) or AGC-FN endocervical subtypes. Conclusion: AGC subcategories defined from LBC, alone or combined with patient age, might be predictors of significant histopathology, cancer incidence, and originating organ.