[Cervical cancer : Update on morphology].

Area of Science:

• Gynecologic Oncology
• Pathology
• Cancer Research

Background:

• The 2014 World Health Organization (WHO) classification details uterine cervical adenocarcinoma subtypes.
• A recently identified gastric subtype shows no association with high-risk human papillomavirus (HPV).
• This gastric subtype is linked to Peutz-Jeghers syndrome and has a poor prognosis, predominantly in women of Asian descent.

Purpose of the Study:

• To review prognostic parameters for uterine cervical adenocarcinomas.
• To discuss the relevance of invasion patterns and tumor size in grading and surgical planning.
• To evaluate the current predictive and prognostic relevance of histological type, molecular parameters, and biomarkers.

Main Methods:

• Review of the 2014 WHO classification of uterine cervical adenocarcinomas.
• Analysis of histopathological parameters relevant for prognosis and treatment.
• Evaluation of the predictive value of histological type, molecular markers, and biomarkers.

Main Results:

• The gastric subtype of mucinous adenocarcinoma is associated with poor prognosis and not linked to HPV.
• Deep stromal infiltration (>66% of cervical stroma) is a key feature of macroinvasive carcinomas.
• Tumor size (e.g., ≤2 cm) may become a discriminator for less radical surgical planning.
• Histological type alone lacks predictive or prognostic relevance for various treatment modalities.
• Currently, molecular parameters and biomarkers hold no prognostic or predictive relevance.

Conclusions:

• Histopathological parameters, particularly invasion patterns and tumor size, are crucial for prognostic assessment and treatment planning in uterine cervical adenocarcinomas.
• The gastric subtype represents a distinct entity with unique clinical and pathological characteristics.
• Further research may refine grading systems and treatment strategies based on these histopathological findings.