[Clinical pathological analysis and immunohistochemical expression of primary cervical adenocarcinoma in 98 cases]

To discuss the pathological classification, immunohistochemical expression characteristics, differential diagnosis and factors affecting prognosis in cervical adenocarcinoma.

Clinical pathological analysis and immunohistochemical study were performed on all primary cervical adenocarcinoma cases (98 patient) from 1991 to 1998. Comparison was made with 18 cases of endometrial adenocarcinoma. 54 cases were followed-up.

These primary cervical adenocarcinoma cases fell into 5 categories, of which the endocervical type being the most common. The positive rate of CEA, HPV16 and HPV6B/11 staining were 15/18 (83.3%), 6/9 (66.7%) and 10/18 (55.6%) cases respectively, while the results of ER and vimentin staining were all negative. PCNA staining was strongly positive in all the cases. In the control group (endometrial adenocarcinoma group) the CEA and vimentin staining positive rates were 27.8% and 83.3% respectively, the difference was significant. The two year follow-up indicated that the incidence of recurrence, metastasis and mortality in the endocervical type were higher that those of other types.

It is difficult to diagnose highly differentiated endocervical adenocarcinoma preoperatively, therefore adequate attention should be attached. Immunohistochemical staining can be used as an important basis for the diagnosis and differential diagnosis of cervical adenocarcinoma. The strongly positive results of PCNA staining, regardless of the degree of differentiation, proves that even highly differentiated adenocarcinoma exhibits a high degree of cell activity. Preliminary data suggests that cervical adenocarcinoma is related to HPV infection. Its relation with each HPV subtype remains to be clarified.