| Cervical cancer, predominantly caused by persistent infections with high-risk human papillomavirus (HPV), remains a
critical health concern worldwide. Atypical glandular cells (AGC) identified on cervical cytology are associated with an
elevated risk of high-grade lesions and invasive cancer, particularly adenocarcinoma, which has poorer prognoses than
squamous cell carcinoma. This study examines histological outcomes in women with AGC, with a focus on HPV-positive
and HPV-negative cases across different age groups, to better understand the impact of HPV status and age on cancer
progression risks. A retrospective cohort of women with AGC findings between February 2018 and June 2019 was
analyzed, categorizing samples by HPV status (<40, 40–50, >50 years). Histopathological diagnoses were classified using
the modified Bethesda system. Results indicated a strong association between HPV-positive status and high-grade lesions,
particularly in younger women. In women under 40, 64% of HPV-positive cases showed high-risk histological outcomes,
compared to only 3.6% in HPV-negative cases. In the 40–50 age group, HPV-positive cases had a 62% positive predictive
value (PPV) for severe outcomes, whereas in women over 50, the PPV declined to 28%, though it remained higher than in
HPV-negative cases. These findings suggest that HPV-positive AGC cases, especially in younger women, are more likely
to progress to high-grade lesions, indicating the need for targeted follow-up. The reduced predictive value in older women
points to potential differences in HPV pathogenesis by age. This study supports the integration of HPV testing with AGC
findings into cervical cancer screening guidelines to enhance risk stratification, optimize patient management, and avoid
unnecessary interventions in low-risk groups. Further research is warranted to explore age-related differences in HPV
progression among AGC casesddd |
