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In this study, 298 pap smears of 60 patients with endocervical adenocarcinoma or adenocarcinoma in situ (AIS) and 30 patients with high\u2010grade intraepithelial lesion (HSIL) in histology were reviewed. The pap smear type (screening\/clinical), the HPV status and the time from sampling to the histological confirmation of diagnosis were recorded for each case. Despite that no cytomorphological features could be associated with adenocarcinoma statistically, 70% of the pap smears were initially correctly diagnosed as an endocervical glandular lesion. Palisading cell borders, nuclear pleomorphism and the lack of single atypical cells present simultaneously were found to be associated with adenocarcinoma and AIS with the corresponding ORs of 5.89 (95% CI 1.96\u201317.70), 3.71 (95% CI 1.14\u201312.02) and 10.76 (95% CI 1.20\u201359.50). This combination of features was seen in smears taken up to 5\u00a0years before the histological diagnosis. Of all our screening samples, 10.9% were HPV\u2010positive. There were no HPV\u2010negative samples among patients with adenocarcinoma.<\/jats:p>","DOI":"10.1111\/apm.13115","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T21:06:04Z","timestamp":1610744764000},"page":"195-203","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The role of Pap smear in the diagnostics of endocervical adenocarcinoma"],"prefix":"10.1111","volume":"129","author":[{"given":"Johanna","family":"Pulkkinen","sequence":"first","affiliation":[{"name":"Pathology Fimlab Laboratories Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heini","family":"Huhtala","sequence":"additional","affiliation":[{"name":"Faculty of Social Sciences Tampere University Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivana","family":"Kholov\u00e1","sequence":"additional","affiliation":[{"name":"Pathology Fimlab Laboratories Tampere Finland"},{"name":"Department of Pathology Faculty of Medicine and Health Technology Tampere University Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,2,2]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"https:\/\/www.who.int\/cancer\/prevention\/diagnosis\u2010screening\/cervical\u2010cancer\/en\/(cited 05.03.2020)."},{"key":"e_1_2_6_3_1","unstructured":"https:\/\/cancerregistry.fi\/screening\/cervical\u2010cancer\u2010screening\/(cited 05.03.2020)."},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.28646"},{"key":"e_1_2_6_5_1","first-page":"1151","article-title":"Cervical cancer: the increasing incidence of adenocarcinoma and adenosquamous carcinoma in younger women","volume":"164","author":"Shiliang L","year":"2001","journal-title":"Can Med Assoc J"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-11074-5_6"},{"key":"e_1_2_6_7_1","first-page":"183","volume-title":"WHO Classification of Tumours of Female Reproductive Organs","author":"Wilbur DC","year":"2014"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-11074-5_5"},{"key":"e_1_2_6_9_1","first-page":"172","volume-title":"WHO Classification of Tumours of Female Reproductive Organs","author":"Stoler M","year":"2014"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2303.2007.00466.x"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000331080"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1159\/000325384"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.23777"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.21724"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2009.05.019"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.2840070203"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1159\/000325682"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000325598"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2007.08.017"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.23452"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10886"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20010225)93:1<8::AID-CNCR9001>3.0.CO;2-K"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/apm.12990"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13013"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2303.2008.00568.x"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.22991"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.22055"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.10061"},{"key":"e_1_2_6_29_1","first-page":"687","article-title":"Cytologic features of squamous cell carcinoma in situ involving endocervical glands in cervical cytobrush specimen","volume":"38","author":"Selvaggi SM","year":"1994","journal-title":"Acta Cytol"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.21471"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2303.2009.00695.x"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9896(199909)189:1<12::AID-PATH431>3.0.CO;2-F"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(10)70230-8"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2014.55"},{"key":"e_1_2_6_35_1","unstructured":"Current Care Working Group.Cytological changes in the cervix vagina and vulva (online). 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