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. 2025 Jan 1;16(2):398-405.
doi: 10.7150/jca.99757. eCollection 2025.

The immediate risk of cancer and its precursor lesions in women with abnormal cervical glandular cytology

Yang Li  1   2 , Yao Chen  1   3 , Wanrun Lin  4 , Keyi Chen  1 , Weiguo Lv  1   5 , Feng Zhou  6   7
Affiliations

The immediate risk of cancer and its precursor lesions in women with abnormal cervical glandular cytology

Yang Li et al. J Cancer. .

Abstract

Objective: This study aims to assess the immediate risk of cervical intraepithelial neoplasia grade (CIN)3+ lesions in women with abnormal cervical glandular cytology. Methods: A total of 403 women with abnormal cervical glandular cytology who underwent simultaneous HPV genotyping and cervical biopsy at the Zhejiang University School of Medicine Women's Hospital, China, between 2016 and 2020, were included in this study. The probability of CIN3+ lesions among women in each group was further analyzed. Results: Subsequently, 26.8% of women with abnormal cervical glandular cytology were diagnosed with CIN3+ lesions. The immediate risk of CIN3+ lesions in the atypical glandular cells, not otherwise specified (AGC-NOS), AGC-favor neoplasia (AGC-N), adenocarcinoma in situ (AIS), and adenocarcinoma (AC) groups were 12.7%, 55.7%, 88.9%, and 92.0%, respectively. The immediate risk of CIN3+ lesions in the AGC-NOS group was significantly lower than in any other groups. The positive rates of hrHPV in the AGC-NOS, AGC-N, AIS, and AC groups were 26.4%, 68.6%, 66.7%, and 56.0%, respectively. The prevalence of CIN3+ in the HPV-16 or 18/45 positive group was significantly higher than in the group of other 11 types positive and hrHPV negative group. Notably, women under 30 years old with AGC-NOS had a low risk of CIN3+ lesions (2.4%). When considering HPV status, the immediate risk of CIN3+ lesions in HPV-negative women was 0.0%. Conclusion: hrHPV genotype and age are valuable indicators to assess the risk of CIN3+ in women with abnormal cervical glandular cytology. Women under 30 years old with AGC-NOS/HPV-negative may have the opportunity to delay colposcopy if appropriate.

Keywords: CIN3+; abnormal cervical glandular cytology; hrHPV; risk stratification.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
The representative images of abnormal glandular cells confirmed by the follow-up histologic examinations: usual type endocervical adenocarcinoma (A); gastric-type endocervical adenocarcinoma (B).
Figure 2
Figure 2
The representative images of usual type endocervical adenocarcinoma (A); gastric-type endocervical adenocarcinoma (B); clear cell adenocarcinoma (C); endocervical adenocarcinoma in situ (D).
See this image and copyright information in PMC

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