A clinical review of borderline glandular cells reported on liquid-based cervical cytology

Authors


Mr Amit Patel, Northern Gynaecological Oncology Centre, Queen Elizabeth Hospital, Sheriff Hill, Gateshead, NE9 6SX, UK. Email amit.patel@ghnt.nhs.uk

Abstract

Please cite this paper as: Patel A, Thampy N, Hemming D, Naik R. A clinical review of borderline glandular cells reported on liquid-based cervical cytology. BJOG 2010;117:1051–1059.

Objective  To review the clinical outcome of women presenting with borderline glandular cells on liquid-based cervical cytology (LBC).

Design  Retrospective review.

Population and setting  Women seen at a colposcopy clinic over a 26-month period referred with borderline glandular cells on LBC.

Methods  Review of the case notes and cytology, pathology and colposcopy databases of all women referred with borderline glandular cells on LBC between June 2006 and August 2008.

Main outcome measures  Final histological diagnosis.

Results  Sixty-nine women were identified (0.19% of all smears). Twenty-seven women (39.1%) had premalignant or malignant lesions, five (7.2%) had cancers and 22 (31.9%) had intraepithelial neoplasia, 19 (27.5%) of which were cervical squamous intraepithelial neoplasia (CIN) and three (4.3%) of which were cervical glandular intraepithelial neoplasia (CGIN). No women under 35 years of age with normal and satisfactory colposcopy had premalignant or malignant lesions. Despite normal and satisfactory colposcopy, three women over 35 years had significant lesions: one high-grade CIN, one CGIN and one squamous cell carcinoma.

Conclusions  On the basis of our results, it would be considered acceptable to manage women under 35 years of age with normal and satisfactory colposcopy conservatively. In women above 35 years of age, we would recommend a diagnostic ‘large loop excision of the transformation zone’ procedure, irrespective of the colposcopic findings.

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