Histogenesis of cervical adenocarcinoma with reference to human papillomavirus-18 as a carcinogen.

Human papillomavirus (HPV) DNA is present in adenocarcinoma of the cervix as frequently as in squamous cell carcinoma of the cervix. Recent molecular biologic studies strongly suggested that HPV acts at least as a cocarcinogen in the female genital organs. Thus, a study of the presence of HPV DNA in adenocarcinoma in situ, endocervical glandular dysplasia and microglandular endocervical hyperplasia, three lesions suggested as possible precursor lesions of adenocarcinoma of the cervix, would clarify some aspects of the histogenesis of adenocarcinoma of the cervix. The presence of HPV-6, HPV-16 and HPV-18 in those precursor lesions was studied with highly sensitive in situ DNA hybridization. Fourteen of 21 cases of adenocarcinoma in situ (67%) contained HPV DNA; approximately the same proportion of HPV DNA was seen in invasive adenocarcinoma. Two of 36 cases of endocervical glandular dysplasia contained HPV DNA; both of them were lesions coexisting with adenocarcinoma in situ and thus might have been well-differentiated lesions of adenocarcinoma in situ. HPV DNA was not present in 16 cases of microglandular endocervical hyperplasia. Adenocarcinoma in situ may be the earliest event in HPV infection of the endocervical cells to lead to the development of adenocarcinoma of the cervix.