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Endocervical adenocarcinoma with a micropapillary component: a clinicopathologic analysis in the setting of current WHO classification

  • 0Department of Gynecology & Obstetrics, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, Zhejiang Province, China.
Virchows Archiv : an International Journal of Pathology +

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November 23, 2024

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November 23, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

The micropapillary structure in HPV-associated endocervical adenocarcinoma indicates worse survival outcomes. This finding aids in prognostic stratification and suggests potential for targeted therapies based on HER2 amplification and gene mutations.

Area Of Science

  • Gynecologic Oncology
  • Pathology
  • Molecular Diagnostics

Background

  • Endocervical adenocarcinoma classification is evolving.
  • The micropapillary component (EAC-MP) requires further clinicopathologic and molecular investigation.
  • Understanding EAC-MP features is crucial for accurate prognosis.

Purpose Of The Study

  • To investigate the clinicopathologic and molecular features of endocervical adenocarcinoma with a micropapillary component (EAC-MP).
  • To evaluate the prognostic significance of the micropapillary component in HPV-associated (HPVA) and HPV-independent (HPVI) endocervical adenocarcinomas.
  • To identify potential therapeutic targets through molecular profiling.

Main Methods

  • Retrospective analysis of 26 EAC-MP cases from 511 adenocarcinomas.
  • Immunohistochemistry and fluorescence in situ hybridization for HER2 status.
  • Targeted next-generation sequencing (NGS) for molecular profiling.
  • Survival analysis comparing EAC-MP subtypes.

Main Results

  • HPV-associated adenocarcinomas with micropapillary components (HPVA-MP) showed larger tumor size, Silva pattern C, deep cervical wall invasion, lymphovascular space invasion (LVSI), lymph node metastasis, advanced FIGO stage, and HER2 amplification compared to non-micropapillary counterparts.
  • HPV-independent adenocarcinomas with micropapillary components (HPVI-MP) had more frequent LVSI than HPVI-NMP.
  • HPVA-MP was associated with significantly worse overall and recurrence-free survival, especially in Silva pattern C cases.
  • NGS revealed mutations in STK11, TERT, ERBB2, TP53, PIK3CA, ARID1A, and NTRK2.

Conclusions

  • The micropapillary structure is an indicator of unfavorable clinical outcomes in HPV-associated endocervical adenocarcinoma.
  • EAC-MP aids in the prognostic stratification of Silva pattern C endocervical adenocarcinoma.
  • HER2 amplification and identified gene mutations present opportunities for future targeted therapies.

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