A Study on Clinical Management of Glandular Changes in Cells on Cervical Cytology

摘要

cqvip:A cytological cervical smear abnormality of glandular origin raises a high suspicion of underlying invasive or pre invasive cancers. Objective: To look into the diagnosis and management of women presenting with glandular changes on cervical cytology and to further implement a good management plan for these women. Methods: This study is a retrospective review of all patients referred to North Cumbria Integrated Care (NCIC) NHS foundation trust, United Kingdom with glandular changes on their cervical smear result between January 2015 and December 2020. Data was collected from the hospital colposcopy data base. Results: This study comprised of a sample size of 65 women. 11 of these (17%) were referred with borderline changes in their endocervical cells and 54 (83%) referred with a ?glandular neoplasia of endocervical type. There were colposcopically significant lesions (high grade lesions or suspected adenocarcinoma) for 52 (80%) of the women. All but one (98%) had Large loop excition of transformation zone (LLETZ) after colposcopy. Histologically, 8 (12%) women were diagnosed with adenocarcinoma, 29 (45%) were diagnosed with high grade cervical glandular intraepithelial neoplasia (HGCGIN), 9 (14%) had high grade cervical intraepithelial neoplasia (CIN2/3), 2 (3%) had low grade cervical glandular intraepithelial neoplasia (LGCGIN), 4 (6%) had a normal histology and 10 (15%) had lesions of mixed origin. After their first LLETZ treatment, 24 (37.5%) needed repeat LLETZ, 8 (12%) had a hysterectomy and one woman had radical trachelectomy.