Clinical significance and management of cervical atypical glandular cells of undetermined significance

CW Chan, KB Cheung
Department of Obstetrics and Gynaecology, Tuen Mun Hospital, Tsing Chung Koon Road, Tuen Mun, Hong Kong

OBJECTIVES. To assess the clinical significance of a cervical cytological diagnosis of atypical glandular cells of undetermined significance and to formulate the most appropriate management guidelines for patients with such a diagnosis.

DESIGN. Retrospective study. SETTING. Regional hospital, Hong Kong.

PATIENTS. Seventy-two patients with diagnoses of atypical glandular cells of undetermined significance who were managed in a colposcopy clinic between January 1998 and December 1999.

MAIN OUTCOME MEASURES. Age, cytological diagnoses of atypical glandular cells of undetermined significance and its subtypes, method of evaluation, final diagnosis, and outcome after 2 years.

RESULTS. Atypical glandular cells of undetermined significance were diagnosed in 83 (0.4%) of 21 854 cervical smear samples taken during the 2-year study period. Follow-up data were available from 72 patients, whose mean age was 43 years (range, 22-69 years). Forty-three percent of these patients had significant diseases of the genital tract. Patients with the subtype diagnosis of atypical glandular cells of undetermined significance–favour neoplasia had the worst outcome, with 90% of patients having significant disease, followed by patients with atypical glandular cells of undetermined significance 'not otherwise specified' (43%), and atypical glandular cells of undetermined significancefavour reactive (8%).

CONCLUSION. Patients with atypical glandular cells of undetermined significance should be investigated early and thoroughly, because many of them will have premalignant or malignant disease.

Hong Kong Med J 2003;9:346-51

Key words: Atypical glandular cell of undetermined significance; Vaginal smears