TITLE:
A Study on Clinical Management of Glandular Changes in Cells on Cervical Cytology
AUTHORS:
Sharadhi Channegowda, Mueed Ijaz, Ayesha Anwar
KEYWORDS:
Glandular Changes, Cervical Cytology, Endocervical Cells
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.12,
December
23,
2021
ABSTRACT: 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.