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Clonal status and clinicopathological observation of cervical minimal deviation adenocarcinoma.

Gong L, Zhang WD, Liu XY, Han XJ, Yao L, Zhu SJ, Lan M, Li YH, Zhang W - Diagn Pathol (2010)

Bottom Line: The results demonstrated that the glands were positive for CEA, Ki-67, and p53 and negative for estrogen receptor (ER), progesterone receptor (PR), and high-risk human papilloma virus (HPV) DNA.Thus, our findings indicate that MDA is a true neoplasm but is not associated with high-risk HPV.Diagnosis of MDA depends mainly on its clinical manifestations, the pathological feature that MDA glands are located deeper than the lower level of normal endocervical glands, and immunostaining.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pathology, Tangdu Hospital, the Fourth Military Medical University, Shaanxi Xi'an 710038, China. lyhzhw@fmmu.edu.cn

ABSTRACT

Background: Minimal deviation adenocarcinoma (MDA) of the uterine cervix is defined as an extremely well differentiated variant of cervical adenocarcinoma, with well-formed glands that resemble benign glands but show distinct nuclear anaplasia or evidence of stromal invasion. Thus, MDA is difficult to differentiate from other cervical hyperplastic lesions. Monoclonality is a major characteristic of most tumors, whereas normal tissue and reactive hyperplasia are polyclonal.

Methods: The clinicopathological features and clonality of MDA were investigated using laser microdissection and a clonality assay based on the polymorphism of androgen receptor (AR) and X-chromosomal inactivation mosaicism in female somatic tissues.

Results: The results demonstrated that the glands were positive for CEA, Ki-67, and p53 and negative for estrogen receptor (ER), progesterone receptor (PR), and high-risk human papilloma virus (HPV) DNA. The index of proliferation for Ki-67 was more than 50%. However, the stromal cells were positive for ER, PR, vimentin, and SM-actin. The clonal assay showed that MDA was monoclonal. Thus, our findings indicate that MDA is a true neoplasm but is not associated with high-risk HPV.

Conclusions: Diagnosis of MDA depends mainly on its clinical manifestations, the pathological feature that MDA glands are located deeper than the lower level of normal endocervical glands, and immunostaining.

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The immunohistochemical staining of SM-actin. The stromal cells were also positive for SM-actin in both MDA and the normal cervical tissues, but the stromal cells with SM-actin positive reactivity were more abundant in MDA (A) than in the normal cervical tissues (B).
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Figure 5: The immunohistochemical staining of SM-actin. The stromal cells were also positive for SM-actin in both MDA and the normal cervical tissues, but the stromal cells with SM-actin positive reactivity were more abundant in MDA (A) than in the normal cervical tissues (B).

Mentions: It showed that CEA, Ki-67 and p53 were expressed in the glandular epithelium of MDA, but not in the normal cervical tissues (Figure 3). Moreover, the normal cervical tissues and stromal cells were found to be positive for ER and PR, but the glandular epithelium were negative for these receptors (Figure 4). Stromal cells were also positive for SM-actin and vimentin in both MDA and the normal cervical tissues, but stromal cells with SM-actin positive reactivity were more abundant in MDA than in the normal cervical tissues (Figure 5).


Clonal status and clinicopathological observation of cervical minimal deviation adenocarcinoma.

Gong L, Zhang WD, Liu XY, Han XJ, Yao L, Zhu SJ, Lan M, Li YH, Zhang W - Diagn Pathol (2010)

The immunohistochemical staining of SM-actin. The stromal cells were also positive for SM-actin in both MDA and the normal cervical tissues, but the stromal cells with SM-actin positive reactivity were more abundant in MDA (A) than in the normal cervical tissues (B).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2877003&req=5

Figure 5: The immunohistochemical staining of SM-actin. The stromal cells were also positive for SM-actin in both MDA and the normal cervical tissues, but the stromal cells with SM-actin positive reactivity were more abundant in MDA (A) than in the normal cervical tissues (B).
Mentions: It showed that CEA, Ki-67 and p53 were expressed in the glandular epithelium of MDA, but not in the normal cervical tissues (Figure 3). Moreover, the normal cervical tissues and stromal cells were found to be positive for ER and PR, but the glandular epithelium were negative for these receptors (Figure 4). Stromal cells were also positive for SM-actin and vimentin in both MDA and the normal cervical tissues, but stromal cells with SM-actin positive reactivity were more abundant in MDA than in the normal cervical tissues (Figure 5).

Bottom Line: The results demonstrated that the glands were positive for CEA, Ki-67, and p53 and negative for estrogen receptor (ER), progesterone receptor (PR), and high-risk human papilloma virus (HPV) DNA.Thus, our findings indicate that MDA is a true neoplasm but is not associated with high-risk HPV.Diagnosis of MDA depends mainly on its clinical manifestations, the pathological feature that MDA glands are located deeper than the lower level of normal endocervical glands, and immunostaining.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pathology, Tangdu Hospital, the Fourth Military Medical University, Shaanxi Xi'an 710038, China. lyhzhw@fmmu.edu.cn

ABSTRACT

Background: Minimal deviation adenocarcinoma (MDA) of the uterine cervix is defined as an extremely well differentiated variant of cervical adenocarcinoma, with well-formed glands that resemble benign glands but show distinct nuclear anaplasia or evidence of stromal invasion. Thus, MDA is difficult to differentiate from other cervical hyperplastic lesions. Monoclonality is a major characteristic of most tumors, whereas normal tissue and reactive hyperplasia are polyclonal.

Methods: The clinicopathological features and clonality of MDA were investigated using laser microdissection and a clonality assay based on the polymorphism of androgen receptor (AR) and X-chromosomal inactivation mosaicism in female somatic tissues.

Results: The results demonstrated that the glands were positive for CEA, Ki-67, and p53 and negative for estrogen receptor (ER), progesterone receptor (PR), and high-risk human papilloma virus (HPV) DNA. The index of proliferation for Ki-67 was more than 50%. However, the stromal cells were positive for ER, PR, vimentin, and SM-actin. The clonal assay showed that MDA was monoclonal. Thus, our findings indicate that MDA is a true neoplasm but is not associated with high-risk HPV.

Conclusions: Diagnosis of MDA depends mainly on its clinical manifestations, the pathological feature that MDA glands are located deeper than the lower level of normal endocervical glands, and immunostaining.

Show MeSH
Related in: MedlinePlus