INTRODUCTION Endocervical glandular atypia is relatively rarely diagnosed by Pap smears. A significant proportion of follow-up histological samples show no premalignant or malignant lesions. The observed cytomorphological findings in premalignant glandular lesions overlap with histologically proven reactive lesions. METHODS A total of 45 conventional Pap smears diagnosed as atypical endocervical cells, not otherwise specified (AEC, NOS) with human papillomavirus (HPV) status available were blindly evaluated in a search for 38 cytomorphological features representing background, architectural, cellular and nuclear features. Of the cases, 30 represented histologically proven benign changes, and 15 represented histologically proven adenocarcinoma in situ (AIS) or endocervical adenocarcinoma (EAC) cases. The benign biopsies were re-evaluated, and the associations of the cytomorphological features or combinations of them with specific histological features and entities were statistically examined. RESULTS The most frequent histological findings in the benign group were squamous metaplasia, inflammation, tubal metaplasia and microglandular hyperplasia. The statistical analysis revealed cytological features associated with squamous metaplastic changes, inflammation and microglandular hyperplasia. Unfortunately, no cytomorphological feature was sufficiently specific to confidently leave the lesion without follow-up and histological correlation. Degeneration and nuclear crowding were the most salient features that distinguished the instances of glandular atypia with benign follow-up histology from those with histologically proven AIS or EAC (26.7% vs. 60.0%, P= 0.030 and 50.0% vs 86.7%, P = 0.017). CONCLUSION Additional methods besides cytomorphology are required to reliably distinguish smears with AEC, NOS harbouring only benign histological changes from those exhibiting endocervical glandular malignancy.

中文翻译：

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传统巴氏涂片中的假阳性非典型宫颈内膜细胞：细胞组织学相关性和分析。

简介 子宫颈抹片检查很少能诊断出宫颈内腺异型性。很大一部分后续组织学样本未显示癌前或恶性病变。在癌前腺体病变中观察到的细胞形态学发现与组织学证明的反应性病变重叠。方法 对总共 45 个诊断为非典型宫颈内膜细胞（未另行指定）（AEC、NOS）且具有人乳头瘤病毒 (HPV) 状态的常规巴氏涂片进行盲法评估，以寻找代表背景、结构、细胞和核特征的 38 种细胞形态学特征。其中，30 例经组织学证实为良性病变，15 例经组织学证实为原位腺癌 (AIS) 或宫颈内腺癌 (EAC) 病例。重新评估良性活检，并统计检查细胞形态学特征或它们的组合与特定组织学特征和实体的关联。结果良性组中最常见的组织学表现是鳞状上皮化生、炎症、输卵管化生和微腺增生。统计分析揭示了与鳞状化生变化、炎症和微腺体增生相关的细胞学特征。不幸的是，没有足够特异性的细胞形态学特征可以在没有后续和组织学相关性的情况下自信地留下病变。变性和核拥挤是区分具有良性后续组织学的腺异型性病例与经组织学证实的 AIS 或 EAC 的最显着特征（26.7% vs. 60.0%，P= 0.030 和 50.0% vs 86.7%，P = 0.017）。结论 除了细胞形态学之外，还需要其他方法来可靠地区分仅含有良性组织学变化的 AEC、NOS 涂片与表现出宫颈内腺恶性肿瘤的涂片。