Comparison Between Pap smear, Colposcopy and Cervical Histopathology Findings in Patients with Atypical Glandular Cells Results in Pap Smears

 The objective of this study was to evaluate colposcopic, endocervical curettage (ECC) and endometrial curettage (EMC) findings in comparison with Pap smears findings.

 Out of 100,000 Pap smears, a total number of 75 eligible women with atypical glandular cells (AGCs) referred to gynecology clinics in Isfahan, Iran, and seventy women were selected to undergo Pap smear test, colposcopic examination and ECC. EMC was performed in women older than 35. Pap smear test results were classified as normal, inflammation, AGCs and necrosis. Colposcopy, ECC and EMC findings were classified as normal, benign and malignant pathologic lesions.

 Repetitive Pap smears findings were as follows: 15.7% were normal, 77.2% had inflammation, 4% had AGC and 3.1% had necrosis. Based on colposcopy findings, 61.2%, 7.5%, and 31.3% of the samples were classified as normal, benign and malignant, respectively. ECC findings in 95.5% of women was indicative of benign lesions and malignant lesions in 4.5%. EMC findings showed that 79.7% were normal, 8.5% had benign lesions and 11.9% had malignant lesions. Pap smears with several AGCs were associated with benign lesions in 24.2% of the cases and premalignant and malignant lesions in 14.2% of the cases.

 According to our study, due to the significant association between AGC cytology and pathologic cervical and endometrial lesions, intensive assessment is necessary in women with AGC Pap smears, especially in older and post-menopausal women, in order to reduce mortality.