Atypical glandular cells of undetermined significance : Cytologic criteria to separate clinically significant from benign lesions

Histologic follow-up of the cervical-vaginal smear diagnosis of atypical glandular cells of undetermined significance (AGUS) shows a broad spectrum of clinically significant (preneoplastic or neoplastic) and benign lesions. There are few statistical studies that have attempted to separate these AGUS categories based on select cytologic criteria. The authors retrospectively reviewed 116 AGUS without concurrent squamous dysplasia smears (66 clinically significant and 50 benign lesions), and used logistic regression analysis to identify the cytologic criteria of irregular nuclear membranes, atypical single cells, and decreased cytoplasm as useful in separating clinically significant from benign lesions. Using contingency tables, these criteria in combination had a sensitivity 29% and a specificity of 94% in the diagnosis of clinically significant lesions. If any single criterion was present, the sensitivity and specificity were 100% and 28%, respectively. In conclusion, by using key cytologic criteria, a percentage of benign AGUS lesions can be separated from clinically significant AGUS lesions.