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

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 (AGC) 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 (HPV16, 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.