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HPV Testing in Women with Atypical Glandular Cytology
Adenocarcinoma in situ (AIS)Endocervical adenocarcinomaEndocervical Glandular Abnormality
HPV16 was seen in ~50% endocervical adenocarcinomaHPV18 was seen in ~32% of endocervicaladenocarcinoma, 4 times higher than SCCHPV18 has been also linked to neuroendocrine carcinoma of the cervix
Adenocarcinoma in Situ (AIS)
Endocervical Adenocarcinoma
TBS: Glandular Cell AbnormalitiesAtypical Glandular Cells (AGC)Favor endocervicalFavor endometrialAtypical Glandular Cells (AGC), favor neoplasticFavor endocervicalFavor endometrialEndocervical adenocarcinoma in situAdenocarcinoma – endocervical, endometrial, extrauterine, NOS
Adenocarcinoma in Situ
Adenocarcinoma in Situ
Adenocarcinoma
THE BETHESDA SYSTEM WEBSITE ATLASAtypical Endocervical Cells or Not?/NIH
Interobserver Reproducibility StudySherman et al. Cancer (Cancer Cytopathology) 2007;111:15–25.1188 responses from Pathologists and Cytotechnologists
Histologic Follow up by Baseline PAP Diagnosis in Women (30-64 yrs)Cytologic Dx# Cases (%)CIN2+AIS+CIN2+/AIS+ (%)Negative923,152 (95.68)25931582751 (0.30)ASC27,050 (2.80)1391391430 (5.29)LSIL9,374 (0.97)1101101111 (11.85)ASC-H1,647 (0.17(28.90)HSIL2,019 (0.21)1204421246 (61.71)AGC2,074 (0.21(10.08)Total965, 360 (100)69133427255 (0.75)Katki HA, et al. J. Lower Genital Tract Disease. 17:S28-35, 2013
2013 ASCCP GuidelineCytologyHPV Testing5 yr Risk CIN2+Recommend ManagementNegativeNegative0.27Repeat testing in 5 yrsNegativePositive10Repeat testing in 6-12 monthsASCNegative1.1Repeat testing in 3 yrsASCPositive18Immediate colposcopy if 25LSILNegative5.1Repeat testing in 6-12 monthsLSILPositive19Immediate colposcopy if 25ASC-HNegative12Immediate colposcopyASC-HPositive45Immediate colposcopyHSILNegative49Immediate colposcopyHSILPositive71Immediate colposcopyAGCNegative2.2Immediate colposcopyAGCPositive45Immediate colposcopySchiffman M and Solomon D. New Engl J Med. 369:24, 2013
A Cleveland Clinic StudyThe
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