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Old 04-21-2010, 10:33 AM   #16
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Re: AGUS/AGC pap results - questions about ECC & endometrial biopsy

Quote:
Originally Posted by Pickle Eyes View Post
From what I've read, the HPV/dna test (which requires a separate swab and can be done at the same time as a pap) has a higher accuracy rate than the HPV test that labs run on tissue taken "just" for a pap.
I'm not sure if this what you are referring to, but the Qiagen/Digene "Hybrid Capture 2" is the test that uses the pap smear sample, and the strain specific uses the "PCR" method, though I really have no idea what the different methods entail, but they actually both have limitations. The PCR testing is more sensitive, but it seems like most doctors seem to prefer the Qiagen because it has a better predictive value for who needs follow up.

The Qiagen requires 5,000 copies present to be postive. They do that purposefully so that minor, unimportant infections do not cause a positive result.

PCR testing is much more sensitive, but apparently that testing method does not pick up HPV DNA that has integrated with the cellular DNA. So PCR testing has the downside of possibly producing negative results in women who has advanced cancer, and possibly missing precancers as well.

So for angel, I would definitely recommend asking your doctor what type of HPV test you had.

As for thoughts on why is was negative...well aparently AGUS paps can be caused by things like cysts or polyps. Also, endometrial glandualar cell changes are not caused by HPV, so deinifelty you will want the endometrial biopsy, but I think non-cancer endometrial abnormalities like endometriosis can cause AGUS paps.

 
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Old 04-22-2010, 01:32 PM   #17
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Re: AGUS/AGC pap results - questions about ECC & endometrial biopsy

Hi there,
I am going through the exact same thing as you. I got a pap that said AGUS nos, I got an ECC and Endo biopsy, plus colposcopy. The pain is determined by the method your doc uses. I asked for the Cytobrush for the ECC...much less painful, but still campy. I just had the ECC 2 days ago. The first one came with CIN 1, my endo was normal. Then my pap came back again with AGUS, Favor Neoplastic. Not good. the last ECC I had on Tuesday hurt a bit more. It is nothing to be scared about though. Take some Ibuprofen. Now, the Endo biopsy is a little more painful. Again it is helpful to know what method is being used. My doc used the Tao Brush. The worst part was when they put the tube into the cervix. The biopsy itself was a bit crampy. My cervix wouldn't open, so they were going to use forceps. I was like "No thanks, just keep trying please!". When it went it it did hurt, for 3 seconds, then he put the brush in and scraped the uterus, which honestly didn't hurt much at all.
I am scared to death. I cannot concentrate on work at all. I am terrfied. I have ovarian cysts that are causing me problems as well. Arrgh! I want the results back so bad.

 
Old 04-23-2010, 06:26 PM   #18
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Re: AGUS/AGC pap results - questions about ECC & endometrial biopsy

Thanks to everyone for sharing your knowledge about HPV testing and non-cancerous causes of AGUS pap results. I really appreciate it!

I received a copy of the lab report, and it says this:

HPV High Risk DNA test. SurePath liquid based specimen

Findings: Negative for High-Risk HPV Types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68

Note: Analyte-specific reagents (ASRs) are used in certain laboratory tests necessary for standard medical care and generally do not require FDA approval. This test was developed and its performance determined by Regional Medical Laboratory. It has not been cleared or approved by the U.S. Food and Drug Administration.


Does this type of testing mean anything to anyone?

Also, the lab report says, "Fungal organisms morphologically consistent with Candida spp." The nurse did not tell me about this on the phone for some unknown reason, but it is not surprising to me because I have a chronic yeast problem due to a medication I take for other health problems. I take acidophilus supplements and use acidophilus creams to keep it in check, but it's not likely to go away.

Does anyone know whether a chronic yeast infection (over the course of years) could cause reactive changes in the glandular cells of the cervix that might show up as "atypical glandular cells" on a pap test? Obviously, I'm still planning to get thorough testing for cancerous causes, but I'm curious whether the candida could be playing a part in this. Your thoughts?

KOSM: I'm sorry to hear what you're going through. I appreciate you sharing about your experiences with the ECC and endo biopsy. The OB/GYN's office said they use a "new method" for the endo biopsy, so I'm hoping it's the Tao brush. With the cytobrush for ECC, do most OB/GYN offices keep this in stock so I can ask for it when I get there?

Thanks again, everyone!

Last edited by angel4747; 04-24-2010 at 09:30 AM. Reason: to clarify post

 
Old 04-24-2010, 10:05 AM   #19
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Re: AGUS/AGC pap results - questions about ECC & endometrial biopsy

Hello!
I have heard that Yeast Infections can mess with pap results, I don't remember where I heard it though and don't know if the info was true. They are trying to diagnose me as well with those gladular changes. I will let you know my bio results this week. As far as the Tao Brush, it comes togther with the Cytobrush. It comes in a kit called the TruTest kit. So, if they use the Tao brush, they will likely use the Cytobrush as well. I hear the Cytobrush is more accurate than the currette for an ECC because it gets cells from all areas of the cervix, whereas the currette only gets one spot. The cytobrush honestly is not that bad at all as far as pain goes. When I found out I needed it done again, I wasn't the least bit nervous because it honestly was no big deal. Definitley caused cramps! The company who makes the TruTest kit is called Gynecore. I called them before my test and asked if they supplied my doctor, they said yes. They were so helpful!

By the way, your result said AGUS, undetermined significance, correct? That is less worrisome than the words "Favor Neoplastic". Your results could be the result of a reactive process, which is benign. That doesn't mean to relax, because AGUS is till associated with a higher risk of premalignancies or malignancy, but not as bad as what my results were, which says "Favor Neoplastic". Favor Neoplastic means more than likely a malignant process.

My results went from being AGUS Unknown signifiance to favor neoplastic within 8 months, so don't mess around. Get the tests done and you will feel lots better. Goodluck, I will say a prayer for you! Let us know how things go!

Last edited by moderator2; 04-24-2010 at 10:28 AM. Reason: please do not promote websites nor post search instructions to find them.

 
Old 05-08-2010, 09:25 AM   #20
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Re: AGUS/AGC pap results - questions about ECC & endometrial biopsy

Well, I finally got my tests done on Thursday. It wasn't easy, but I'm thrilled to have it over with.

As expected given my AGUS pap result, I had a colposcopy with 2 biopsies, an ECC, and an endometrial biopsy. I didn't feel much pain at all with the first two procedures (thank goodness!) and the doctor didn't have any trouble moving the instruments through the cervical canal, but the endometrial biopsy itself was quite painful. The pain was far more than "bad cramps" as I've heard it described. Unfortunately, I think they used the pipelle method rather than the Tao brush, so perhaps that's the reason for the high level of pain. The doctor started the biopsy and said "I'll need to do this for about 30 seconds." And I said, "OH OH OH (in pain)...30 seconds, really? Please hurry, hurry, hurry!" I think she stopped after 15 seconds, thank goodness, because I'm not sure how much more I could have taken. Hopefully the sample was large enough, because I definitely don't want to have that done again!

Unfortunately, the doctor said she saw two white spots on the outer cervix/transformation zone during the colposcopy. She said they weren't "overly concerning" and that "they might be something or might be nothing." She biopsied both sites, so we'll see. I'm pretty bummed about that, but I guess I'll be thankful if they can find the problem quickly so this doesn't turn into a never-ending "treasure" hunt.

It's still possible that the spots she saw were yeast patches, given that my pap results showed Candida. After my last post, I actually contacted the pathologist to ask if Candida could cause the AGUS pap results. He was extremely helpful and said it was definitely possible, and that Candida could affect squamous cells too. I'm still hopeful that yeast could be the culprit, but my gut says this probably isn't the case. I hope the test results come back quickly next week so I don't have to wait much longer to find out.

In answer to a previous question, my PAP results showed "atypical glandular cells" only, with no mention of "favor neoplastic." That's somewhat reassuring, but I know an AGUS pap of any type is pretty concerning. My OB/GYN is taking it very seriously and plans to continue an aggressive workup if needed, so I think I'm in good hands. Depending on what comes back from the recent biopsies, I may still consult with a gyn oncologist for a second opinion before going any further.

Thanks again for all your help and support!

 
Old 05-08-2010, 11:18 AM   #21
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Re: AGUS/AGC pap results - questions about ECC & endometrial biopsy

Glad that you got all of that done and over with. Sorry it was so painful. I definitley think the method has a lot to do with it. If it was the Tao Brush, you would have seen a brush that looks similiar to a really big mascara brush, but white. The Pipelle, I believe, uses a suction method of taking cells. The Tao brush is simply a scraping that takes all of about 10 seconds. But for me, that tube that guides the brush in is what caused me the most pain for the whole thing. Feels good to get these things over with.
Not having that "Favor neoplastic " qualifier is a good thing. I had a friend who had AGUS like you, had the biopsies and it was truly nothing at all. Then again, it could be something so you do need to get checked, which you have, and soon you will have more information. To reassure you, my ECC results came back with CIN 1, cannot rule out High grade lesion. The endometrial biopsy came back normal. I started taking Pro-biotics because I heard the same thing you did, that yeast can cause this result. So, I took the pro-biotics and my last ECC came back no CIN, just rare atypical cells. However, another pap showed favor neoplastic, which is bad. I also had an ultrasound done. Ttally painless, and if you have a massive tumor, it will show it.
If they cannot diagnose the cause of your glandular abnormalities, your next step may be a cone biopsy. I gotta have one of those in June. Not looking forward to it.

 
Old 05-17-2010, 06:43 PM   #22
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Re: AGUS/AGC pap results - questions about ECC & endometrial biopsy

Hi ladies,

Last week I got my biopsy results, and given the previous AGUS pap test, I think it's the best result I could've hoped for!

I don't have a copy of the pathology report yet, but here's what the nurse told me:
  • Cervical biopsies: atypical squamous metaplasia
  • ECC: focal reactive atypia
  • Endometrial biopsy: negative!
  • Note: Benign cellular changes

From what I understand, the metaplasia noted in the cervical biopsies has nothing to do with dysplasia, and only represents an area of the cervix where the cells change over from squamous to glandular.

When I talked to the nurse, she said the doctor was planning to talk with the pathologist to ensure that these results match up with the AGUS pap result, given that there was nothing mentioned about glandular cells in the pathology report. It's been almost a week since they got the results and I haven't heard back yet, so I think this is probably a good sign. If I haven't heard back from the doctor by later this week, I'm planning to give her a call to find out what the game plan is. I'm assuming I'll still need to be followed closely by repeat pap tests, but we'll see.

After my previous conversation with the pathologist, I feel pretty confident that the benign atypical cells (both glandular and squamous) could have been caused by my 4-year bout with chronic yeast infections. The 2 "suspicious" cervical biopsies were taken from the transformation zone, so both glandular and squamous cells could be affected in this area. Also, if there were atypical cells found on the ECC, I assume those must have been glandular since I'm under the impression that the cervical canal is made up of glandular cells. (Don't quote me on this though!)

If you ladies have any concerns or comments about the above, I'd welcome your feedback! I definitely want to make sure I have all my bases covered.

Thanks again for your support during this extremely stressful time. I feel so relieved and fortunate that things are looking up!

Angel

 
Old 05-18-2010, 08:32 AM   #23
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Re: AGUS/AGC pap results - questions about ECC & endometrial biopsy

I really cant comment about the ECC however, I found out yesturday I have to have one June 8th. My doctor said it is like having a the procedure colposcopy (sp??) which I have had at LEAST four times. My experience with that was fine. A little cramping and spotting after. It felt like cramps! I take ibuprofen 800mg before I go. So if the ECC is anything like getting pieces of your cervix snipped...you can do this!!! If I can anyone can (I am a big baby!). I will say a prayer for us both.

 
Old 06-26-2010, 06:09 AM   #24
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Re: AGUS/AGC pap results - questions about ECC & endometrial biopsy

Angel, I've read your posts with great interest as I has atypical glandular cells with a Pap in Jan. Following this, Ive had a colposcopy, d & c, LEEp, cone, and ultimately a hysterectomy on May 28. I am wondering about those glandular cells and although everyone, including my gyn-onc was convinced the hys would end my troubles, I have been diagnosed with a rare gynecological cancer known as adnoma malignum or minimally deviant adenocarcinoma. I hope all has gone well for you and if you get a chance, tell me of your hopeful progress. I was anxious about the glandular cells from ther beginning asnd I suppose, my fears have been confirmed.

 
Old 07-05-2010, 07:34 AM   #25
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Re: AGUS/AGC pap results - questions about ECC & endometrial biopsy

Hi Ladies,
I have been reading your posts since my last pap in Feb showed AGUS favor neoplastic. I have had a colonsocopy, biopsies, an ultrasound, and a cold knife which were all normal. I don't go back to the gyn for 6 months to have another pap, ECC, and colonoscopy. Is there anyone else who has had AGUS and the cause was not found? I have read a lot and know that the cells may come from outside the reproductive tract. I also had a pap which showed AGUS six years ago.
Donna

 
Old 07-05-2010, 12:27 PM   #26
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Re: AGUS/AGC pap results - questions about ECC & endometrial biopsy

I have the exact same thing...well, kind of...mine said atypical endocervical glandular cells, favor neoplastic. They cannot find the cause. My endometrial biopsy was normal. ECC showed CIN 1, which later regressed and said reactive. I had an MRI because of pain which showed I have Adenomyosis. Adenomyosis is endometriosis taht is inside the muscle of the uterus (myometrium). It causes excess gland cells to show up but still my doc doesn't think it caused the pap result. I am pretty scared as well. I have heard that in rare cases this can result from someone going on with other organs, such as the colon. I would request a pelvic/abdominal MRI with contrast. That should rule out any malignancies. Maybe a few blood tests (CA-125). Was the cone surgery real bad? What is there next step with you? I feel for ya! Will keep you in my prayers!

 
Old 07-05-2010, 04:06 PM   #27
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Re: AGUS/AGC pap results - questions about ECC & endometrial biopsy

Thanks for your reply. My CA125 is slightly elevated. I have asked for an abdominal ultrasound but my gyn won't order one since my cone biopsy was normal. She said that the abdomen isn't her area and she wouldn't know what to do with the results anyway. I do have endometriosis but haven't been told if this could be the cause of the agus favor neoplastic.....so far I have no idea where the abnormal cells are originating from. The cone wasn't nearly as bad as I thought it would be. I thought the bleeding would be quite heavy but it wasn't. I had a brown discharge for about 4 weeks. I didn't need any pain medication. I have been having trouble with acid reflux for months now. I had a gastroscopy done and see my dr on Fri for results. I don't go for further testing until Nov which will be more than a year since my original diagnosis. Then she will do a repeat pap. ECC and colposcopy. I had a colonscopy a year ago since colon cancer runs in my family. Are you having a cone? ...what is next for you? Thanks again for responding to my post. It isn't easy to find someone else who has this diagnosis. I will keep you in my thoughts and prayers too.

 
Old 07-05-2010, 10:16 PM   #28
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Re: AGUS/AGC pap results - questions about ECC & endometrial biopsy

I would take comfort in the fact that you had a normal Cone biopsy. They are very accurate!! I would have another endometrial biopsy and also an ultrasound to see if your endometrial stripe is normal. You could have hyperplasia. When I complained of pelvic pain, no one took me that seriously (and the pain was reallly bad), so finally I went to a gastroenterologist and he ordered the pelvic MRI for me. It was very helpful and I really think that would help you too. The MRI would show any tumor formation, or any other abnormalities as well. I would insist on one! My cone is supposed to be Wednesday, not looking forward to it. Not to mention my period is a week early and I am not sure I can have the procedure while on my period. Ugh!! I am so sick of this

 
Old 07-06-2010, 07:57 AM   #29
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Re: AGUS/AGC pap results - questions about ECC & endometrial biopsy

Good luck with your cone. I hope you can get it overwith. I had a virus in my chest and the gyn postphoned mine for 3 weeks until I had a lung CT. I know how awful the waiting is. I am with you ....I am sick of this too. My Agus favor neoplastic pap was at the end of Feb. and I got the results the end of March. Life has been very uncertain since then. How long have you been dealing with this? Let me know how you make out. I'll be thinking of you.

 
Old 07-06-2010, 09:06 AM   #30
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Re: AGUS/AGC pap results - questions about ECC & endometrial biopsy

Hi Donna,
I have been trying to keep sane by praying and leaving it with God, but it isn't easy. I Google too much info and end up getting myself worked up. I tried to Private Message you but it wouldn't work! Send me a private message if you want to talk. It is really hard to find someone else with this diagnosis. I got my results in January.

 
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