University of Massachusetts Medical School Faculty Publications

Title

The Cellient automated cell block system is useful in the differential diagnosis of atypical glandular cells in Papanicolaou tests

UMMS Affiliation

Department of Pathology

Publication Date

1-1-2014

Document Type

Article

Subjects

Adenocarcinoma; Adult; Aged; Aged, 80 and over; Automation; Biopsy, Needle; Carcinoma, Squamous Cell; Cohort Studies; Diagnosis, Differential; Female; Humans; Immunohistochemistry; Middle Aged; Neoplasms, Glandular and Epithelial; Papanicolaou Test; Retrospective Studies; Sensitivity and Specificity; Tissue Embedding; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms

Disciplines

Diagnosis | Neoplasms | Obstetrics and Gynecology | Pathology

Abstract

BACKGROUND: Atypical glandular cells (AGC) is a very important diagnosis in gynecological cytology. In the current study, the authors investigated the usefulness of Cellient cell blocks (CB) for characterizing AGC on Papanicolaou (Pap) tests.

METHODS: A total of 148 patients with an AGC diagnosis based on Pap tests by cytotechnologists and referred to cytopathologists were studied. Among these patients, there were 68 patients with CB preparations and 80 patients with Pap tests only (TP-AGC group). Follow-up results by Pap tests or biopsies were obtained in 117 of 148 patients. The median follow-up was 13 months (range, 1 month-36 months).

RESULTS: Of the 68 patients with CBs, 31 (46%) were reclassified as negative for dysplasia or low-grade intraepithelial lesion; 30 patients (44%) retained a diagnosis of AGC (CB-AGC group); and 7 patients (10%) were given specific diagnoses of high-grade intraepithelial lesion (3 patients), endocervical adenocarcinoma in situ (1 patient), and invasive adenocarcinoma (3 patients). On follow-up, the CB-AGC group was found to have a significantly lower rate of negative/low-grade squamous intraepithelial lesion diagnoses compared with the TP-AGC group (55% vs 85%; P = .006). The CB-AGC group had a significantly higher rate of endocervical or endometrial adenocarcinoma compared with the TP-AGC group (36% vs 8%; P = .003) at the time of follow-up. The rates of high-grade squamous intraepithelial lesion were not found to be statistically different between these 2 groups (9% vs 7%; P = .66).

CONCLUSIONS: The Cellient CB is a useful technique to further categorize a diagnosis of AGC on Pap tests. Using the Cellient CB system, the pathologist has the ability to improve the diagnostic accuracy of AGC so that unnecessary colposcopic evaluation or biopsies can be avoided.

Rights and Permissions

Citation: Cancer Cytopathol. 2014 Jan;122(1):8-14. doi: 10.1002/cncy.21343. Epub 2013 Aug 20. Link to article on publisher's site

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

Cancer cytopathology

PubMed ID

23963870