Atypical glandular cells (AGC) are a rare cytological finding in cervical screening. Diagnosis of glandular lesions presents a number of difficulties. In recent years, studies have debated the need for AGC subcategories due to their varying prognostic significance.

OBJECTIVE

To evaluate the frequency of occurrence of atypical glandular cells in patients with diagnosed uterine body cancer, the effectiveness of the cytological method in the diagnosis of glandular lesions, as well as the clinical significance of AGC subcategories.

MATERIAL AND METHODS

To assess the frequency of detection of endometrial cells during cervical screening in patients with uterine body cancer, the results of 197 patients examined for 2021—2022 were included. A comparative retrospective analysis of the results of a cytological examination of 320 smears was carried out followed by a histological examination of the material in the period from 2018 to 2022. The efficiency indicators of the cytological method were calculated.

RESULTS

Endometrial cells in patients with confirmed uterine body cancer were detected in 41.1% of cases. The sensitivity of the cytological method in diagnosing glandular lesions was 83.8% (95% 77.7—88.8%), specificity 88.8% (95% 82.2—93.60%), PPV — 91.2% (95% 85.7—94.98%), NPV — 79.9% (95% 72.5—85.9%). Statistically significant differences in the probability of detecting a malignant neoplasm or neoplastic process were obtained depending on the cytological conclusion in the following categories: NILM, EM and ADC, EM (p<0.001); AGC NOS, EM and AGC FN, EM (p=0.019); AGC NOS, EM and ADC, EM (p<0.001); AGC NOS, EC and ADC, EC (p=0.009).

CONCLUSION

The cytological method has high efficiency rates for diagnosing glandular lesions. By subdividing the AGC NOS category into EC/EM and AGC FN into EC/EM, the prognostic significance of the cytological report for the further management of patients increases.