[Significant pathologic findings in 41 Atypical Glandular Cell pap smears]

The aim of this study was to evaluate the association between atypical glandular cell [AGC] on Pap smear and significant pathologic finding to tailor management protocols. Between 2002 and 2005, Among 26893 Pap smears 122 women with AGC Pap smears [prevalence=0.45%] were referred to our colposcopy clinic. Forty one women underwent colposcopy directed biopsy, endocervical curettage, endometrial sampling and cervical conization to determine the cytologic and histologic correlations of AGC on pap smears. A total of 122 women with AGC Pap smear were found. Only 41 women accepted to participate in the study and followed the workup procedures. The mean age of the patients was 46.92 +/- 11.48 years [range, 23-80 years]. Of these patients 13 patients [31.7%] were post menopause and 28 patients [68.2%] were in reproductive age. We found 13 [31.7%] significant pathologic findings including 4 [9.7%] high grade squamous intraepithelial lesion [HG-SIL], 3[7.3%] low grade squamous intraepithelial lesion [LG-SIL], 2[4.8%] Endometrial hyperplasia, 1[2.4%] Endometrial adenocarci-noma, 1[2.4%] adenocarcinoma of cervix, 1[2.4%] squamous cell carcinoma of cervix and 1[2.4%] papillary serous tumor of ovary. There was not any significant difference in the prevalence of significant pathologic findings and subtype of squamous or adenomatous lesions between pre and postmenopausal group. AGC on Pap smear was associated with a clinically significant diagnosis in approximately one third of our cases. The women with a diagnosis of AGC on cervicovaginal smear are needed to be evaluated at least with colposcopy, endocervical and endometrial curettage. Clinicians should be careful about the significance of AGC in pap smears

[Symptoms of ovarian cancer in young patients: a case control study in IRAN, 1998-2005]

Ovarian cancer is usually diagnosed after it has widely spread and is difficult to cure. Most of attempts to identify its early symptoms have either lacked a control group or have been based on interviews of patients with possible recall bias, and most studies have been performed on all age groups. To examine the early symptoms of ovarian cancer in young women aged between 15 and 35 compared with a matched control group. Hundred women with ovarian cancer were selected out of 565,611 women aging 15 to 35 years who were referred to Vali-Asr Gynecology Oncology Clinic of Imam Khomeini Hospital between 1998 and 2005. Symptoms of 100 cases were compared with those of 100 matched control women during one year before diagnosis. The proportion of cases who complained of at least one symptom up to one year before the diagnosis was significantly higher than controls, 95% versus 28%, respectively [p<0.05]. Most of these symptoms were abdominal in nature. Other symptoms included urinary problems, infertility and abnormal vaginal bleeding. The most common symptoms among cases were: unusual abdominal or lower back pain [52%], unusual bloating, fullness and pressure in the abdomen [37%], gastro-intestinal problems [36%], and unusual lack of energy [22%]. The proportion of controls reporting these symptoms were 11%, 3%, 12% and 7%, respectively, resulting in odds ratios [95% confidence intervals] of 8.765 [4.18-18.355], 18.989 [5.614-64.228], 4.125 [1.991-8.546], and 3.747 [1.520-9.237] for these symptoms, respectively. There were only minor differences between cases with early and late stage disease. Unusual abdominal or lower back pain, unusual bloating, fullness and pressure, gastro-intestinal problems, frequent urination, urgency or burning, and infertility should make women and physicians more aware of possible changes associated with ovarian cancer in young women