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[A clinicopathological study on minimal deviation adenocarcinoma of uterine cervix]
Xianying Yao1, Zhilan Peng, Kaixuan Yang
1West China Hospital, Sichuan University, Chengdu 610041, China.
Objective:
Minimal deviation adenocarcinoma (MDA) is frequently underdiagnosed in pathology tests due to its benign histopathological features. Therefore, its clinical and pathological characters need to be further analyzed and to establish useful immunohistochemical markers to improve the accuracy of pathological diagnosis.
Methods:
Clinical pathology data were of 13 MDA cases collected and analyzed in the First and Second Hospitals attached to the University, the pathological characters were compared with matched benign hyperplastic and atypical hyperplastic controls of the glandular epithelial cells to find histochemical and immunohistochemical indices valuable for the pathological diagnosis. 8 of these 13 cases were followed and their conditions were discussed.
Results:
The main clinical symptoms were watery leucorrhagia, enlargement of the cervix with erosion and hardening. Thickened ligaments were also detected in some cases. The pathological findings included hyperplasia and mild abnormality of the glands, invasion effects into the stroma could be observed in some glands and abortive glands with desmoplastic changes, or edema and inflammatory infiltration around the glands were also observed. The invasion presented in the deep part of the cervix as well, some were found near larger blood vessels or in the small vessels. Compared with benign glands, the immunohistochemical indices of most MDA glands were demonstrated as cancer embryo antigen (CEA) + + +, Ki-67 +--+ + +, P53 +--+ + +, AB/PAS +/+ +, and focal defect on the basement membrane.
Conclusions:
Once any of the diagnostic characters summarized as above was determined, the probability of MDA should be seriously considered, at least atypical hyperplasia in cervical glands must be diagnosed, and follow-up on the patients and histological biopsy of deep tissues (> 5 mm) of the cervix will be necessary to determine the inclusion/exclusion of MDA. Obviously, a correct pathological diagnosis is extremely important for the patient to receive proper treatment in time and thereby improve her quality of life.
