A Retrospective Pathology Review of Atypical Glandular Cells: hrHPV Status and Glandular Neoplastic Outcomes.

Authors

Tanya Li, Julia Kaskey, Johanna Rivas, Ameera Syed, Peter Schnatz, Xuezhi Jiang

Published in

Journal of lower genital tract disease. Oct 02, 2026. Epub Oct 02, 2026.

Abstract

To evaluate the relationship between high-risk human papillomavirus (hrHPV) status and glandular neoplastic outcomes in women with atypical glandular cells (AGC) and to characterize the clinicopathologic features of hrHPV-negative AGC.
We evaluated 230,780 cervical cytology results collected from January 1, 2005 to June 1, 2017, identifying 698 (0.3%) AGC cases. Demographics, age at AGC diagnosis, Pap and reflex hrHPV results, and final AGC-related pathology were recorded. Associations between hrHPV status and glandular neoplastic outcomes were evaluated using the χ2 test.
Among 698 women with AGC, 315 (45.1%) had hrHPV data, including 130 (41.3%) hrHPV-positive and 185 (58.7%) hrHPV-negative. The remaining 383 (54.9%) had no reflex hrHPV performed because of no squamous abnormalities. Of the 463 with pathology results, 49 (10.6%) had endometrial or endocervical cancer, including adenocarcinoma in situ. Of the 49, 8 (16.3%) were hrHPV-positive, 11 (22.4%) were hrHPV-negative, and 30 (61.3%) had unknown hrHPV. Of the 240 with hrHPV and pathology available, the incidence of glandular neoplastic lesions did not differ between hrHPV-negative and hrHPV-positive women (7.8% vs 8.1%; relative risk=1.04, 95% CI=0.43-2.48; p=.94). Women with glandular neoplastic lesions were significantly older at AGC diagnosis than those without neoplasia [mean (SD) age: 55.5 (16.1) vs 44.8 (11.6); p<.001].
AGC is associated with a significant risk of glandular neoplastic lesions, particularly among older women. hrHPV-negative AGC does not exclude clinically significant glandular neoplasia, supporting the diagnostic value of cervical cytology in AGC evaluation. These findings should be interpreted in the context of a historical, preprimary hrHPV screening practice.

PMID:
42826253
Bibliographic data and abstract were imported from PubMed on 03 Oct 2026.

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