Description

ABSTRACT

The aims of this study were to review the diagnostic pathway and management of women referred with abnormal smears reported as ‘glandular neoplasia’; to assess the correlation of cytological and histological diagnosis and to assess the outcomes after referral to colposcopy following a LBC showing abnormal glandular cells and the compliance with NHSCSP guideline. Retrospective review of cervical glandular intraepithelial neoplasia over a 5 year period from 2009 to 20013 has been presented. . Total of 45 women with abnormal glandular smears were identified during this period from the Caledonian Colposcopy database at the Royal Derby Hospital. A retrospective review of the case notes was carried out to collect demographic information, referral interval to colposcopy clinic and details of colposcopic findings and treatment procedure carried out along with histolopathological findings including information relating to excision margins, final diagnosis and subsequent follow up and cytology results. About half of the women with abnormal glandular cells (48%) were in age group of 25-35 years at the time of referral. (Mean age 36.3). 15 % of women with abnormal glandular cells were nulliparous. Majority of referred smears are abnormal glandular cells. 41 women with abnormal glandular smear were seen in colposcopy clinic within 2 weeks of referral (91% Compliance). 95% of women had excisional treatment at their first visit (95% Compliance). 71 % women had complete excision with disease free margins. 4% of women needed repeat excision and out of those 4 %, 17 % needed hysterectomy. Histology showed 22 % of women had invasive carcinoma, 13 % had concomitant CIN and 20% had CIN alone. Out of 45 cases, 27% of women needed hysterectomy and more than half of the women needed radical hysterectomy. 1 woman needed chemoradiation due to the advanced disease at the time of diagnosis. No recurrence case was noted during study period. Immediate referral for colposcopy and detailed assessment by experienced colposcopy team is recommended.

Keywords: Cervical glandular intraepithelial neoplasia, abnormal glandular smears, Caledonian Colposcopy database, colposcopy, histopathology, cervical cytology