[Diagnostic approaches of cervical glandular intraepithelial neoplasia]

To investigate diagnostic approaches of cervical glandular intraepithelial neoplasia (CGIN) for improving the diagnostic levels of CGIN.

Clinical data of 106 cases with CGIN admitted in hospital from Jan.2008 to Dec. 2010 were analyzed retrospectively.All data from preoperative thin-prep cytologic test (TCT), cervical biopsies and postoperative pathological examination of the excised cervical tissues were reviewed.

Among 106 patients, 62 cases (58.5%, 62/106) were low grade CGIN (L-CGIN), 44 cases (41.5%, 44/106) were high grade CGIN (H-CGIN); 25 cases (23.6%, 25/106) were pure CGIN and 81 cases (76.4%, 81/106) were CGIN mixed with cervical intraepithelial neoplasia (CIN). Fifteen cases (14.2%, 15/106) were found atypical glandular cell (AGC) by TCT. In the 15 cases, there were 4 cases (6.5%, 4/62) L-CGIN, and 11 cases (25.0%, 11/44) H-CGIN, there was significant difference between the two groups (P < 0.05); among 15 cases with AGC, 11 cases of them (44.0%, 11/25) were pure CGIN, 4 cases (4.9%, 4/81) mixed with CIN, in which there were significant difference (P < 0.01).Seven cases (25.0%, 7/28) were detected glandular lesions in 28 cases by endocervical curettage (ECC). Totally 23 cases (22.8%, 23/101) were detected CGIN by colposcopy-directed biopsy, 11 cases (19.0%, 11/58) were with L-CGIN, 12 cases (27.9%, 12/43) H-CGIN, there was no significant difference between them (P > 0.05).Among the 23 cases, 13 cases (52.0%, 13/25) were pure CGIN, 10 cases (12.3%, 10/81) CGIN mixed with CIN, which showed significant difference (P < 0.01). All 106 patients were treated, 101 cases treated with cervical conization and 5 cases performed hysterectomy; 23 cases were diagnosed CGIN preoperation, the ratio of preoperative diagnosis was 21.7% (23/106), 83 cases (80.3%, 83/106) diagnosed postoperatively.

Routine diagnostic methods of CGIN were not satisfaction, most CGIN were diagnosed after cervical resection.Cervical conization may play a very important role in diagnosis of CGIN.The positivity of TCT in H-CGIN was higher than L-CGIN. There was no different in diagnosing different CGIN grades by colposcopy-directed biopsy. The ratio of preoperative diagnosis of pure CGIN was higher than those with CGIN mixed with CIN.