Authors:
Cullimore J. Scurr J.
Institution
J. Cullimore, Obstetrics and Gynaecology, Princess Margaret
Hospital, Swindon, Wiltshire SN1 4JU; United Kingdom.
Title:
The abnormal glandular smear: Cytologic prediction, colposcopic correlation and clinical management (2000-3159).
Source:
Journal of Obstetrics and Gynaecology. Vol 20(4) (pp03-407), 2000.
Abstract:
We reviewed recent cytological reporting of abnormal glandular cells on PAP test (cervical smear)s in order to assess the predictive value of these reports and the contribution of colposcopy in the assessment of these abnormalities. The study consisted of a 5-year retrospective review of the clinical management of 80 women with abnormal glandular cells on a PAP test (cervical smear), with clinical and histopathological data available for review in the interval 1992-1996. There were two groups of women: (i) those referred with gynaecological symptoms and (ii) those with screen detected abnormalities who were asymptomatic and significantly younger than the first group. The predictive value of a glandular smear for malignancy was 42.5% and for premalignancy 28.8%. The most common lesions detected were cervical intraepithelial neoplasia (CIN) (13), endometrial cancer (13), cervical adenocarcinoma (10) and cervical intraepithelial glandular neoplasia (CIGN) (8). Four cases of endometrial carcinoma presented through screening. In the remainder a variety of benign conditions were identified as responsible for the abnormal smear. Failure to find an explanation for the abnormal smear only occurred in 8.8%. In developing a protocol for abnormal glandular smears, our observations indicate that: (a) those with abnormal bleeding require endometrial sampling; (b) for those with screen detected abnormality, colposcopy is valuable as it is a sensitive predictor of early invasion and can predict glandular abnormality; (c) diseases of the entire genital tract, non-gynaecological viscera and metastatic cancer can generate cytological abnormality; (d) screen detected borderline abnormality in endocervical cells is associated with CIN III.
Please click on the required question.
- 1 What is the cervix?
- 2 What is a cervical polyp?
- 3 What is meant by cervical erosion (ectopy) and cervicitis?
- 4 What is the transformation zone?
- 5 What is a 'Paptest' (PAP test (cervical smear) test)
- 6 My PAP smear test (cervical smear) shows inflammation. Should I be worried?
- 7 What are cells and what is an abnormal (pre- malignant) cell?
- 8 My PAP smear test (cervical smear) shows abnormal cells. Does this mean that I have cancer?
- 9 What is meant by the terms pre-malignant cells, dyskaryosis, dysplasia and CIN?
- 10 What are the symptoms of pre-malignancy of the cervix?
- 11 What are benign and malignant tumours?
- 12 Why have I developed a pre-malignant condition of my cervix?
- 13 What is colposcopy?
- 14 What treatments are available for pre-malignant conditions of the cervix?
- 15 Can pre-malignant conditions of the cervix be cured?
- 16 How can I be re-assured that the pre-malignant changes will not recur?
- 17 How can we prevent carcinoma of the cervix?
- 18 Is there a reason to screen for HPV?
- 19 Support Groups.
- 20 Are there any support groups?
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