Ondrej Ondič1,2, Jana Němcová1,2, Reza Alaghehbandan3, Kateřina Černá1,2, Barbora Gomolčáková2, Iva Kinkorová-Luňáčková2, Jan Chytra4, Henrieta Šidlová5,6, Marta Hósová7, Jiří Bouda4. 1. Department of Pathology, Medical Faculty, Charles University Hospital Pilsen, Charles University, Pilsen, Czech Republic. 2. Bioptická laboratoř, s.r.o., Pilsen, Czech Republic. 3. Department of Pathology, Royal Columbian Hospital, University of British Columbia, Vancouver, BC, Canada. 4. Department of Gynecology and Obstetrics, Medical Faculty, Charles University Hospital Pilsen, Charles University, Pilsen, Czech Republic. 5. Cytopathos, s.r.o., Bratislava, Slovak Republic. 6. Department of Pathology, Slovak Medical University, Bratislava, Slovak Republic. 7. Department of Pathology, Nemocnice Na Bulovce, Praha, Czech Republic.
Abstract
BACKGROUND: It is generally acknowledged that interobserver variability for the histological diagnosis of endocervical adenocarcinoma (EA) subtypes is suboptimal. The recently proposed International Endocervical Adenocarcinoma Criteria and Classification (IECC) system is based on the presence of associated human papilloma virus (HPV) infection. It recognises HPV-associated EAs and non-HPV-associated EAs. METHODS: This prospective cytology-histology and molecular genetics-based study investigated the potential effect of IECC being applied to Papanicolaou (Pap) test with regard to the diagnostic accuracy of severe glandular lesions reported at least as adenocarcinoma in situ (AIS). RESULTS: Out of 118 liquid-based cytology Pap tests with AIS+ lesion, complete information on follow-up biopsy and HPV status was available in 51 cases. AIS and EA category correlated with histologically confirmed AIS/EA in 88.5% (23/26) and 70.5% (12/17) of cases, respectively. Interestingly, 93% (40/43) of cases diagnosed as AIS/EA were HPV positive and 7% (3/43) were HPV negative (originating in the cervix, endometrium and adnexa). CONCLUSIONS: Our findings suggest that this approach could possibly divide Pap tests containing severe glandular lesion into two groups: (a) robust diagnosis of HPV-associated EA and (b) non-HPV associated glandular lesions of heterogeneous origin, requiring further clinical preoperative diagnostic workup.
BACKGROUND: It is generally acknowledged that interobserver variability for the histological diagnosis of endocervical adenocarcinoma (EA) subtypes is suboptimal. The recently proposed International Endocervical Adenocarcinoma Criteria and Classification (IECC) system is based on the presence of associated human papilloma virus (HPV) infection. It recognises HPV-associated EAs and non-HPV-associated EAs. METHODS: This prospective cytology-histology and molecular genetics-based study investigated the potential effect of IECC being applied to Papanicolaou (Pap) test with regard to the diagnostic accuracy of severe glandular lesions reported at least as adenocarcinoma in situ (AIS). RESULTS: Out of 118 liquid-based cytology Pap tests with AIS+ lesion, complete information on follow-up biopsy and HPV status was available in 51 cases. AIS and EA category correlated with histologically confirmed AIS/EA in 88.5% (23/26) and 70.5% (12/17) of cases, respectively. Interestingly, 93% (40/43) of cases diagnosed as AIS/EA were HPV positive and 7% (3/43) were HPV negative (originating in the cervix, endometrium and adnexa). CONCLUSIONS: Our findings suggest that this approach could possibly divide Pap tests containing severe glandular lesion into two groups: (a) robust diagnosis of HPV-associated EA and (b) non-HPV associated glandular lesions of heterogeneous origin, requiring further clinical preoperative diagnostic workup.
Authors: Simona Stolnicu; Lien Hoang; Noorah Almadani; Louise De Brot; Glauco Baiocchi; Graziele Bovolim; Maria Jose Brito; Georgia Karpathiou; Antonio Ieni; Esther Guerra; Takako Kiyokawa; Pavel Dundr; Carlos Parra-Herran; Sofia Lérias; Ana Felix; Andres Roma; Anna Pesci; Esther Oliva; Kay J Park; Robert A Soslow; Nadeem R Abu-Rustum Journal: Pathology Date: 2022-04-30 Impact factor: 5.335