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International Endocervical Adenocarcinoma Criteria and Classification (IECC): correlation with adverse clinicopathological features and patient outcome.
- Source :
-
Journal of clinical pathology [J Clin Pathol] 2019 May; Vol. 72 (5), pp. 347-353. Date of Electronic Publication: 2019 Jan 24. - Publication Year :
- 2019
-
Abstract
- Aims: The International Endocervical Adenocarcinoma Criteria and Classification (IECC) was recently proposed as an improved method for categorising endocervical adenocarcinoma (EA) into human papillomavirus (HPV)-associated adenocarcinomas (HPVAs) and non-HPV-associated adenocarcinomas (NHPVAs). Such categorisation correlates with patient age and tumour size; however, its association with patient outcome remains to be established.<br />Methods: Institutional cases of EA with histological material available were selected. Three gynaecological pathologists independently classified all tumours according to the IECC with consensus review used when necessary. Clinicopathologic variables were recorded for each case.<br />Results: Of a total of 87 EAs, 71 (82%) were classified as HPVA and 16 (18%) as NHPVA. Among HPVA, most were usual type (51/71, 72%) followed by mucinous not otherwise specified (10/71, 14%) and invasive stratified mucin-producing carcinoma (ISMC, 8/71, 11%). Most NHPVAs were of gastric type (12/16, 71%) followed by clear cell and mesonephric (two each, 12%). Compared with HPVAs, NHPVAs were significantly associated with older age (p<0.001), larger horizontal extent (p=0.013), greater depth of invasion (p=0.003), lymphovascular space invasion (p<0.001), advanced stage (p<0.001) and invasive pattern C (p<0.001). On univariate analysis, worse disease-free survival (DFS) and disease-specific survival (DSS) correlated with NHPVA group. Among the HPVA subtypes, ISMC showed worse DFS and DSS compared with other HPVA types.<br />Conclusions: The simple morphological approach of the IECC appears to be prognostically valuable. NHPVA (in particular gastric type) and ISMC (a recently recognised subset of HPVA) have an adverse outcome and their recognition following the IECC is important. We provide further evidence to replace the current WHO classification with the IECC.<br />Competing Interests: Competing interests: None declared.<br /> (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)
- Subjects :
- Adenocarcinoma diagnosis
Adenocarcinoma pathology
Adenocarcinoma virology
Adolescent
Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Middle Aged
Papillomavirus Infections diagnosis
Papillomavirus Infections pathology
Prognosis
Proportional Hazards Models
Uterine Cervical Neoplasms diagnosis
Uterine Cervical Neoplasms pathology
Uterine Cervical Neoplasms virology
Young Adult
Adenocarcinoma classification
Papillomavirus Infections complications
Uterine Cervical Neoplasms classification
Subjects
Details
- Language :
- English
- ISSN :
- 1472-4146
- Volume :
- 72
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of clinical pathology
- Publication Type :
- Academic Journal
- Accession number :
- 30679193
- Full Text :
- https://doi.org/10.1136/jclinpath-2018-205632