Histologic significance atypical glandular cellsofthe program for prevention of cervical cancer in the cityof Rio de Janeiro

Abstract

The objective of this study was to identify the prevalence of AGC pap smears with subsequent biopsy correlation in the program area AP-5.1 of Rio de Janeiro city. This is a cross-sectional study, which analyzed cytopathologic records, using the computerized data SITEC/INCA/MS, from January 2002 to December 2008. In that period 132,147 exams from the screened women, were recorded in the archives of SITEC. Of this total, 533 had an initial cytologic diagnosis of AGC with an overall prevalence of 0.4%. Considering the age, 79.2% (417/533) of women with first and 82,6% (19/23) with second AGC cytology ranged from 25 to 54 years. A total of 69.4% (370/533) of women underwent colposcopy and a second pap smear. The non-attendance rate was 30.6% (163/533). The new cytological results revealed that 67.5% (250/370) of the pap smears were normal, 24.5% (91/370) were represented by atypical squamous cells and only 7.8% (29/370) by atypical glandular cells of varying severity. Among the 23 women with second AGC cytology, 43.5% (10/23) had normal histology, 43.4% (10/23) had squamous lesion, 8.7% (2/23) had invasive adenocarcinoma and 4.34% (1/23) the result was inconclusive. In conclusion, the prevalence of the AGC in the AP-5.1 was low. Most women with AGC cytology result had normal histology or squamous lesions which focused more often on young adult women. Although the minority of the lesions were derived from glandular epithelium, it was significantly worse because it was invasive. Women with AGC cytology should continue the investigation with colposcopy and directed biopsy because they may present serious squamous or glandular lesions.