Research

Management of women with cytological glandular lesions of uterine cervix: New literature data

Nikolaou Marinos1, Papadimitriou Ifigenia2, Michail George2, Androutsopoulos George2, Adonakis George2, Relakis Konstantinos3, Decavalas George2

1Department of Obstetrics and Gynecology, Agios Nikolaos hospital, Agios Nikolaos, Crete, Greece
2Department of Obstetrics and Gynecology, University of Patras, Medical School, Patras, Greece
3Department of Obstetrics and Gynecology, University of Crete, Medical School, Herakleio, Crete, Greece

Correspondence: Nikolaou Marinos, Department of Obstetrics and Gynecology, Agios Nikolaos hospital, Agios Nikolaos, GR – 72100, Greece, E – mail: nikolaoumarinos@yahoo.gr



Abstract

The incidence of cervical glandular lesions has significantly increased during the past two decades especially among young women. This rise in registered cases is predominantly attributed to this entity’s rising prevalence as well as recent advances in cytology. Atypical glandular cells identified by secondary cervical screening (Papanicolaou) might actually harbor significant underlying pathology. The natural history and progression of cervical glandular lesions comparing to that of their squamous counterparts is less well understood. High-risk HPV’s (HPV 16, 18 and 45) have been identified in glandular lesions with high frequency. Cytology and colposcopy illustrate poor sensitivity in the diagnosis of glandular lesions. Diagnostic excisional procedures are of paramount importance in the management of high – grade glandular lesions. Treatment options are conservative surgery, predominantly conization or definitive therapy (mainly hysterectomy). Cervical conization appears to give satisfactory results especially in young women with high grade glandular lesions who strongly wish to preserve their fertility potential. However, adequate counseling should be provided to patients before therapeutic decisions. Long – term follow – up is mandatory for women treated for glandular lesions to detect any possible residual disease and early signs of recurrence.

Keywords: cervical glandular lesions, diagnostic investigations, treatment options

p.  11-24