Pap smears with glandular cell abnormalities: Are they detected by rapid prescreening?. Issue 12 (8th September 2015)

• Record Type: Journal Article
• Authors: Kanber, Yonca; Charbonneau, Michele; Auger, Manon
• Is Part Of: Cancer cytopathology. Volume 123:Issue 12(2015:Dec.)
• Page Start: 739
• Page End: 744
• Publication Date: 2015-09-08
• Subjects: atypical glandular cells (AGC) -- glandular cell abnormalities -- rapid prescreening -- rescreening; Cancer -- Cytopathology -- Periodicals; Pathology, Cellular -- Periodicals; Cytology -- Technique -- Periodicals; 611.01815
• DOI: 10.1002/cncy.21601
• Languages: English
• ISSNs: 1934-662X

Abstract

Abstract : BACKGROUND: Rapid prescreening (RPS) is one of the quality assurance (QA) methods used in gynecologic cytology. The efficacy of RPS has been previously studied but mostly with respect to squamous lesions; in fact, there has been no study so far specifically looking at the sensitivity of RPS for detecting glandular cell abnormalities. METHODS: A total of 80, 565 Papanicolaou (Pap) smears underwent RPS during a 25‐month period. A sample was designated as "review for abnormality" (R) if any abnormal cells (at the threshold of atypical squamous cells of undetermined significance/atypical glandular cells [AGC]) were thought to be present or was designated as negative (N) if none were detected. Each sample then underwent full screening (FS) and was designated as either R or N and also given a cytologic interpretation. RESULTS: The final cytologic interpretation was a glandular cell abnormality (≥AGC) in 107 samples (0.13%); 39 of these (36.4%) were flagged as R on RPS. Twenty‐four patients (33.8%) out of 71 who had histologic follow‐up were found to harbor a high‐grade squamous intraepithelial lesion or carcinoma; 13 of those 24 Pap smears (54.2%) had been flagged as R on RPS. Notably, 11 AGC cases were picked up by RPS only and not by FS and represented false‐negative cases; 2 of these showed endometrial adenocarcinoma on histologic follow‐up. CONCLUSIONS: Pap smears with glandular cell abnormalities are often flagged as abnormal by RPS, and this results in a sensitivity of 36.4% (at the AGC threshold). Most importantly, some cases of AGC are detected on Pap smears by RPS only, and this demonstrates that RPS is a valuable QA method. Cancer (Cancer Cytopathol) 2015;123:739–744. © 2015 American Cancer Society . Abstract : A significant fraction (36.4%) of atypical glandular cell lesions are identified by rapid prescreening; some of these (10.3%) are picked up by rapid prescreening only (and not by full screening). Rapid prescreening helps to reduce the false‐negative rate of atypical glandular cells in gynecologic cytology.