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The Utility of Human Papillomavirus Testing in Young Women With Atypical Glandular Cells on Pap Test

Crothers, Jessica W. MD1; Mount, Sharon L. MD1; Harmon, Maureen MD1; Wegner, Elisabeth MD2

Journal of Lower Genital Tract Disease: January 2015 - Volume 19 - Issue 1 - p 22–26
doi: 10.1097/LGT.0000000000000044
Original Articles: Cervix and HPV Clinical Research

Objective: This study aimed to gain information regarding the follow-up diagnoses and human papillomavirus (HPV) status of women younger than 35 years diagnosed with atypical glandular cells (AGCs) on Pap test.

Materials and Methods: This is a retrospective observational study in which the cytopathology files at Fletcher Allen Health Care were reviewed from 2000 to 2013 for the diagnoses of AGC in women younger than 35 years. Subsequent pathology reports and HPV testing results were obtained. Significant lesions were defined as cervical intraepithelial neoplasia (CIN) 2 or 3, invasive squamous cell carcinoma, adenocarcinoma in situ, or adenocarcinoma.

Results: One hundred six women younger than 35 years with an AGC Pap diagnosis and subsequent follow-up were identified. Significant lesions were diagnosed in 44.3% of the women (47); the majority (55.3%, 26 patients) of which were classified as CIN 2 or 3. Adenocarcinoma in situ was diagnosed in 27.7% of the cases (13). A diagnosis of both CIN 2 or 3 and adenocarcinoma in situ was made in 14.9% of the cases (7). One patient (2.1%) was diagnosed with endometrial adenocarcinoma. The HPV status was identified in 36.8% of the women (39): 69.2% (27) was HPV positive, and 30.8% (12) was HPV negative. Fifty-five percent of HPV-positive women were diagnosed with a significant lesion upon follow-up. No known HPV-negative women were diagnosed with a significant lesion.

Conclusions: Human papillomavirus testing may be useful in risk stratifying young women with AGC on Pap test because they are at risk of having an HPV-positive cervical lesion.

Human papillomavirus testing in women younger than 35 years with atypical glandular cells on Pap test may be useful for risk stratification and triage.

Departments of 1Pathology, and 2Obstetrics Gynecology and Reproductive Medicine, University of Vermont/Fletcher Allen Health Care, Burlington, VT

Reprint requests to: Jessica W. Crothers, MD, Department of Pathology, Fletcher Allen Health Care, 111 Colchester Ave, Burlington, VT 05401. E-mail: Jessica.Wood@vtmednet.org

The authors have declared they have no conflicts of interest.

Copyright © 2015 by the American Society for Colposcopy and Cervical Pathology