Detecting uterine glandular lesions: Role of cervical cytology

BACKGROUND: The sensitivity of cervical cytology for detection of glandular lesions is reported to be low. We conducted this study to assess the diagnostic accuracy of cervical Papanicolaou (Pap) smears for uterine glandular lesions and to compare the diagnostic utility of conventional and liquid-based cytology (LBC) smears for glandular lesions. MATERIALS AND METHODS: Archived histopathology records of all cases reported as endocervical and endometrial adenocarcinoma in the study period were identified and the available corresponding Pap smears (in preceding 1 year) were retrieved. In addition, the Pap smears reported as glandular cell abnormalities (GCA) during the same study period were retrieved. The overall prevalence of GCA, sensitivity, and specificity of Pap smears for the detection of GCA was calculated. The diagnostic accuracy of conventional and LBC smears for the diagnosis of GCA was also compared. RESULTS: The prevalence of GCA in our study was 0.32%. The overall specificity of Pap smears for the diagnosis of GCA was 60.8%, this was not significantly different between conventional and LBC smears (P = 0.4). The overall sensitivity of Pap smears for the detection of GCA was 41.8%; LBC smears had significantly better sensitivity as compared to conventional smears for the detection of endometrial as compared to endocervical adenocarcinoma (P < 0.05). CONCLUSIONS: The prevalence of GCA in Pap smears is low. The specificity of Pap smears, for diagnosis of GCA, was found to be moderate. However, the overall sensitivity of Pap smears for the detection of GCA was low, though better for LBC as compared to conventional smears.