Affiliation:
1. Departments of Pathology International Peace Maternity and Child Health Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China
2. Department of Pathology Zhejiang University School of Medicine Women’s Hospital Hangzhou Zhejiang Province China
3. Laboratory of Pathology National Cancer Institute National Institutes of Health Bethesda Maryland USA
4. Carlson School of Chemistry and Biochemistry Clark University Worcester Massachusetts USA
5. Department of Biology University at Albany Albany New York USA
6. Department of Pathology University of Texas Southwestern Medical Center Dallas Texas USA
Abstract
AbstractBackgroundThis study aims to assess the immediate risk of cervical precancers and cancers in women with atypical glandular cells (AGC) cytology, based on high‐risk human papillomavirus (hrHPV) genotypes and age.MethodsA retrospective analysis was conducted on 369 cases of AGC with immediate follow‐up biopsy results, including 299 AGC‐not otherwise specified (NOS) and 70 AGC‐favor neoplastic (FN).ResultsAmong the 369 AGC cases, 127 tested positive for hrHPV (34.4%). The predominant high‐risk type was other 11 genotypes (44.1%), followed by 16+ (29.1%), 18/45+ (26.0%), and 16 and 18/45 double‐positive (0.79%). Precancers and cancers were detected in 30.4% (112 of 369) and 9.8% (36 of 369) of cases, respectively. The HPV‐18/45+ group had notably higher adenocarcinoma in situ and adenocarcinoma (AIS+) prevalence compared to other 11 genotype groups (p < .0001 and p = .001, respectively). The HPV‐16+ group showed significantly higher high‐grade cervical squamous epithelial lesion and squamous cell carcinoma prevalence than other 11 genotype groups (p < .0001 and p = .017, respectively). Using 40‐year cutoff, older women had significantly higher prevalence of abnormal glandular lesion+ lesions (17.6% vs. 7.6%, p = .005) and adenocarcinoma (AC) (12.4% vs. 2.5%, p = .001). Using 50‐year cutoff, older women had higher prevalence of squamous cell carcinoma (SCC) (3.3% vs. 0.4%, p = .042) and AC (15.2% vs. 5.8%, p = .005). Subgroup analysis revealed that AGC‐FN women showed more severe cervical pathology than AGC‐NOS women (p < .001).ConclusionsAGC women have a significantly increased risk of cervical precancerous lesions and cancer. HPV genotyping and patient age factors need to be taken into consideration in the clinical management process of AGC patients.