OBJECTIVE: To evaluate the prevalence and histologic outcomes of patients with atypical glandular cells of undetermined significance (AGUS), diagnosed by Pap test, and concurrent risk factors. DATA SOURCES: A PubMed/MEDLINE/Ovid HealthStar search of the English literature was conducted from January 1988 through March 2004. METHODS OF STUDY SELECTION: The search criteria included the terms "atypical glandular cells of undetermined significance," "AGUS," or "AGC." All studies investigating the clinical significance of patients with an AGUS Pap test were included, except for those where consecutive Pap tests were not studied. Diagnostic outcomes were then determined. TABULATION, INTEGRATION, AND RESULTS: Of the 916 studies identified, 24 met our inclusion criteria. Of the 2,389,206 Pap tests included in these studies, 6,829 (0.29%) had AGUS. Follow-up was available for 3,890 tests. These data showed the following rates of pathology: 8.5% low-grade squamous intraepithelial lesions (LSIL), 11.1% high-grade squamous intraepithelial lesions (HSIL), 2.9% adenocarcinoma in situ, 1.4% endometrial hyperplasia, and 5.2% malignancy. The most common malignancies were endometrial adenocarcinoma (57.6%), cervical adenocarcinoma (23.6%), ovarian and fallopian tube carcinoma (6.4%), squamous cell carcinoma of the cervix (5.4%), and other (6.9%). Of the AGUS Pap tests, the remaining 71.0% corresponded to benign findings, including reactive changes, polyps, and normal histology. Patients with AGUS, which favors a neoplastic process, or with a concurrent ASCUS have a greater likelihood of disease. CONCLUSION: Histologic diagnosis showed that 29.0% of these Pap tests had findings requiring follow-up or therapeutic intervention, including a 5.2% rate of malignancy. Based on these findings, 99.6% of the diagnoses are within the region of surveillance when AGUS Pap tests are evaluated with colposcopy and directed biopsy, endocervical curettage, an endometrial biopsy in patients with risk factors for endometrial cancer, and pelvic examination.
OBJECTIVE: To evaluate the prevalence and histologic outcomes of patients with atypical glandular cells of undetermined significance (AGUS), diagnosed by Pap test, and concurrent risk factors. DATA SOURCES: A PubMed/MEDLINE/Ovid HealthStar search of the English literature was conducted from January 1988 through March 2004. METHODS OF STUDY SELECTION: The search criteria included the terms "atypical glandular cells of undetermined significance," "AGUS," or "AGC." All studies investigating the clinical significance of patients with an AGUS Pap test were included, except for those where consecutive Pap tests were not studied. Diagnostic outcomes were then determined. TABULATION, INTEGRATION, AND RESULTS: Of the 916 studies identified, 24 met our inclusion criteria. Of the 2,389,206 Pap tests included in these studies, 6,829 (0.29%) had AGUS. Follow-up was available for 3,890 tests. These data showed the following rates of pathology: 8.5% low-grade squamous intraepithelial lesions (LSIL), 11.1% high-grade squamous intraepithelial lesions (HSIL), 2.9% adenocarcinoma in situ, 1.4% endometrial hyperplasia, and 5.2% malignancy. The most common malignancies were endometrial adenocarcinoma (57.6%), cervical adenocarcinoma (23.6%), ovarian and fallopian tube carcinoma (6.4%), squamous cell carcinoma of the cervix (5.4%), and other (6.9%). Of the AGUS Pap tests, the remaining 71.0% corresponded to benign findings, including reactive changes, polyps, and normal histology. Patients with AGUS, which favors a neoplastic process, or with a concurrent ASCUS have a greater likelihood of disease. CONCLUSION: Histologic diagnosis showed that 29.0% of these Pap tests had findings requiring follow-up or therapeutic intervention, including a 5.2% rate of malignancy. Based on these findings, 99.6% of the diagnoses are within the region of surveillance when AGUS Pap tests are evaluated with colposcopy and directed biopsy, endocervical curettage, an endometrial biopsy in patients with risk factors for endometrial cancer, and pelvic examination.
Authors: L Stewart Massad; Xianhong Xie; Teresa M Darragh; Howard Minkoff; Alexandra M Levine; Gypsyamber D'Souza; Anthony Cajigas; Christine Colie; D Heather Watts; Howard D Strickler Journal: Obstet Gynecol Date: 2009-11 Impact factor: 7.661
Authors: Rita Singhal; Lisa V Rubenstein; Mingming Wang; Martin L Lee; Anwar Raza; Christine H Holschneider Journal: J Gen Intern Med Date: 2008-02-20 Impact factor: 5.128
Authors: Randy L Carter; Le Kang; Kathleen M Darcy; James Kauderer; Shu-Yuan Liao; William H Rodgers; Joan L Walker; Heather A Lankes; S Terence Dunn; Eric J Stanbridge Journal: Cancer Causes Control Date: 2012-10-17 Impact factor: 2.506
Authors: Yuxuan Wang; Lu Li; Christopher Douville; Joshua D Cohen; Ting-Tai Yen; Isaac Kinde; Karin Sundfelt; Susanne K Kjær; Ralph H Hruban; Ie-Ming Shih; Tian-Li Wang; Robert J Kurman; Simeon Springer; Janine Ptak; Maria Popoli; Joy Schaefer; Natalie Silliman; Lisa Dobbyn; Edward J Tanner; Ana Angarita; Maria Lycke; Kirsten Jochumsen; Bahman Afsari; Ludmila Danilova; Douglas A Levine; Kris Jardon; Xing Zeng; Jocelyne Arseneau; Lili Fu; Luis A Diaz; Rachel Karchin; Cristian Tomasetti; Kenneth W Kinzler; Bert Vogelstein; Amanda N Fader; Lucy Gilbert; Nickolas Papadopoulos Journal: Sci Transl Med Date: 2018-03-21 Impact factor: 17.956