In the high‐income countries, the amount of cervical adenocarcinomas is on the rise. The pap smear sampling has a low sensitivity and a low specificity for endocervical malignancies, and there are only a few cytomorphological features, that are specifically associated with glandular atypia. In this study, 298 pap smears of 60 patients with endocervical adenocarcinoma or adenocarcinoma in situ (AIS) and 30 patients with high‐grade intraepithelial lesion (HSIL) in histology were reviewed. The pap smear type (screening/clinical), the HPV status and the time from sampling to the histological confirmation of diagnosis were recorded for each case. Despite that no cytomorphological features could be associated with adenocarcinoma statistically, 70% of the pap smears were initially correctly diagnosed as an endocervical glandular lesion. Palisading cell borders, nuclear pleomorphism and the lack of single atypical cells present simultaneously were found to be associated with adenocarcinoma and AIS with the corresponding ORs of 5.89 (95% CI 1.96–17.70), 3.71 (95% CI 1.14–12.02) and 10.76 (95% CI 1.20–59.50). This combination of features was seen in smears taken up to 5 years before the histological diagnosis. Of all our screening samples, 10.9% were HPV‐positive. There were no HPV‐negative samples among patients with adenocarcinoma.

中文翻译：

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子宫颈抹片检查在宫颈内膜腺癌的诊断中的作用

在高收入国家，宫颈腺癌的数量正在上升。子宫颈抹片检查对宫颈内恶性肿瘤的敏感性低且特异性低，并且仅有少数细胞形态学特征，这些特征与腺异型症特别相关。在这项研究中，从组织学上对60例宫颈内膜腺癌或原位腺癌（AIS）和30例高度上皮内病变（HSIL）的298例宫颈涂片进行了回顾。记录每个病例的子宫颈抹片涂片类型（筛查/临床），HPV状态以及从取样到组织学确诊的时间。尽管统计学上没有细胞形态学特征与腺癌相关，但最初正确诊断出70％的宫颈涂片为宫颈内腺病变。发现腺癌和AIS与细胞边界，核多态性和同时存在的单个非典型细胞缺失有关，其OR分别为5.89（95％CI 1.96–17.70），3.71（95％CI 1.14–12.02）和10.76。 （95％CI 1.20–59.50）。在组织学诊断之前长达5年的涂片中可见到这种特征的组合。在所有筛查样本中，有10.9％是HPV阳性。腺癌患者中没有HPV阴性样品。在组织学诊断之前长达5年的涂片中可见到这种特征的组合。在所有筛查样本中，有10.9％是HPV阳性。腺癌患者中没有HPV阴性样品。在组织学诊断之前长达5年的涂片中可见到这种特征的组合。在所有筛查样本中，有10.9％是HPV阳性。腺癌患者中没有HPV阴性样品。