[Cervical glandular intraepithelial neoplasia: a clinicopathologic and immunohistochemical analysis of 80 cases]

To assess the clinicopathologic characteristics of cervical glandular intraepithelial neoplasia (CGIN) and to evaluate the usefulness of EnVision immunohistochemistry of various markers in identifying early invasive cervical adenocarcinoma (ICA) and its precursor lesions.

Clinical and pathological characteristics of 80 cases of high grade CGIN (HCGIN), 20 ICA, and 20 cervicitis were reviewed along with immunohistochemical studies of p16, Ki-67, CEA, CA125 and bcl-2.

The clinical features of HCGIN were similar to those of high grade cervical intraepithelial neoplasia (CIN). Fourty four cases (55.0%) accompanied with CIN and 9 cases (11.3%) accompanied with early cervical squamous cell carcinoma (SCC). The positive rates of p16, CEA and Ki-67 in 80 cases of HCGIN were 100.0%, 63.8% and 73.8%, respectively. The positive rates of p16, CEA and Ki-67 in 20 ICA were 18/20, 16/20 and 20/20, respectively. The positive rates of p16, CEA and Ki-67 in 20 cervicitis were 1/20, 1/20 and 3/20, respectively. There was a significantly increased expression of p16, CEA and Ki-67 in ICA and HCGIN compared with cervicitis (P < 0.01). Ki-67 expression increased in ICA compared to HCGIN (P < 0.05). There was no statistical difference in CEA expression between ICA and HCGIN (P > 0.05). CA125 showed strong but nonspecific expression. Bcl-2 was negative or occasionally positive in each groups.

HCGIN is frequently accompanied with CIN and SCC. The combined staining of p16, CEA and Ki-67 provides additional aid in the diagnosis of early stage cervical adenocarcinoma and its precursor lesions. The sensitivity of p16 and Ki-67 markers for HCGIN is higher than that of CEA. CA125 and bcl-2 immunostains offer no helpful in identifying HCGIN.