scholarly journals Invasive Stratified Mucin-Producing Carcinoma (ISMC) of The Uterine Cervix: A Clinicopathological Study of 8 Cases

Author(s):  
Tingting Li ◽  
Sixia Xie ◽  
Yichao Qiu ◽  
Shuang Yuan ◽  
Wei Wang ◽  
...  

Abstract Invasive stratified mucin-producing carcinoma (ISMC) is a rare gynecologic malignancy. Previous studies suggested that ISMC was a morphologic variant of invasive cervical adenocarcinoma. The clinicopathologic features and prognosis of eight cases of ISMC are presented. Clinical symptoms and imaging were atypical. Four cases were pure ISMCs, and four cases were ISMCs mixed with usual-type endocervical adenocarcinomas. The depths of stromal invasion were more than half (5/8), with approximate full-thickness in one case, and there was vascular invasion (5/8), neutral invasion (3/8), uterine segment involvement (3/8), and parametrial involvement (1/8). One of the patients underwent vaginal cuff surgery. Lymph node metastasis was seen in two patients (2/8). All cases were diffusely positive for p16 and high Ki67 expression. These cases had high-risk HPV16,18, 58 infection. All patients were alive after surgery and adjuvant therapy during the 8- to 21-month follow-up, and only one developed vaginal wall recurrence at 15 months. The present data and those obtained from the literature suggest that ISMC is an invasive endocervical adenocarcinoma with high-risk HPV infection, mainly HPV18, and has a risk of recurrence and metastasis.

2018 ◽  
Vol 30 (1) ◽  
pp. 56-63 ◽  
Author(s):  
Sebastián Videla ◽  
Antoni Tarrats ◽  
Arelly Ornelas ◽  
Roger Badia ◽  
Eva Castella ◽  
...  

Currently, Papanicolaou smears are proposed at three-year intervals for cervical screening to all women living with HIV. The aim of this retrospective cohort study was to provide data on the incidence of cervical high-grade squamous intraepithelial lesions (HSIL) in cervical smear confirmed by histology in HIV-1-infected women (two consecutive normal Papanicolaou smears at baseline) after a long-term follow-up. Sixty-seven women (recruited between March 1999 and January 2003) were analyzed. The median period of follow-up was 13.2 years (range: 7.4–17.1 years) with a total of 583 Papanicolaou smears. Twenty-seven percent of these HIV-1-infected women had poorly-controlled HIV. Cumulative incidence of HSIL was 18% (12/67; 95%CI: 11–29%) of which one was an invasive squamous cell carcinoma and two were carcinoma in situ. These women had not been well-engaged with the annual Papanicolaou smear screening program and had poor adherence to antiretroviral therapy. Development of HSIL was associated with high-risk-HPV infection (OR: 14.9; 95%CI: 3.0, 75.1). At last Papanicolaou smear, prevalence of high-risk-HPV infection was 30% (20/66, 95%CI: 21–42%). In conclusion, the incidence of cervical HSIL in HIV-1-infected women with poor antiretroviral therapy adherence or poor immunological status reinforces the need to identify those HIV-1-infected women at risk of developing cervical cancer.


2020 ◽  
Vol 18 ◽  
pp. 205873922093308
Author(s):  
Gao Yuan

This study was designed to investigate the correlation between high-risk human papillomavirus (HPV) infection and the expression of IHC markers (ER, PR, p53, Ki67) in patients with different grades of cervical intraepithelial neoplasia (CIN). It was a retrospective study, which was conducted from June 2016 to June 2018. 140 specimens of CIN were collected from the pathology department of a certain hospital that included 40 specimens of CIN1, 50 specimens of CIN2 and 50 specimens of CIN3. The expression of ER, PR, P53 and Ki67 were determined by immunohistochemistry. The high-risk HPV infections were detected by PCR fluorescence quantification and were given the correlation analysis. In the 140 specimens, the positive rates of HPV16 and HPV18 in CIN1 specimens were 27.5% and 25.0% respectively, and in CIN2 specimens were 64.0% and 60.0% respectively, and in CIN3 specimens were 90.0% and 92.0% respectively, the difference were statistically significant (p<0.05). There were no significant correlation (p<0.05) between HPV16 and HPV18 positive rate and patient age, tissue differentiation, and tumor size. With the increased of CIN grade, the positive rate of ER, PR, P53 and Ki67 expression in specimen were also increased significantly, and the difference were statistically significant (p<0.05). Pearson correlation analysis showed there were positive correlation (p<0.05) between the positive rates of HPV16 and HPV18 and the positive rates of ER, PR, P53 and Ki67. With the increase of CIN level, the positive rates of high-risk HPV infection as well as ER, PR, P53 and Ki67 are increased, and they have positive correlation.


Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 1947
Author(s):  
Daniela Cabibi ◽  
Caterina Napolitano ◽  
Antonino Giulio Giannone ◽  
Maria Carmela Micciulla ◽  
Rossana Porcasi ◽  
...  

P16 immunostaining is considered a useful surrogate of transcriptionally active high-risk (hr) HPV infection. Only strong and widespread “block-like” immunoreactivity is considered specific, whereas weak/focal p16 positive immunostaining is considered not specific, and follow-up and HPV molecular detection is not indicated. The aim of the study was to evaluate the presence of HPV DNA and Ki67 immunostaining in 40 cervical atypical biopsies (CALs) with mild and focal histological features suggestive of HPV infection—20 cases with weak/focal p16 positive immunoreactivity and 20 cases negative for p16 expression. In 16/20 weak/focal p16 positive CALs (80%), the INNO-LiPA HPV genotyping detected hrHPV genotypes (HPV 31, 51, 56, 59, 26, 53, 66, 73, and 82). Co-infection of two or more hrHPV genotypes was often evidenced. HPV16 and 18 genotypes were never detected. Ki67 immunostaining was increased in 10/20 cases (50%). In 19/20 p16 negative CALs, hrHPV infection was absent and Ki67 was not increased. These results suggest that weak/focal p16 immunostaining represents the early stage of transcriptionally active infection, strongly related to the presence of less common hrHPV genotypes, probably with a slower transforming power, but with a potential risk of progression if the infection persists. HPV DNA genotyping and follow-up could be useful in these cases to verify if they are able to evolve into overt dysplastic changes and to improve knowledge of less common hrHPV genotypes.


2015 ◽  
Vol 4 (5) ◽  
pp. 261-266 ◽  
Author(s):  
Anna Woodard ◽  
R. Marshall Austin ◽  
Zaibo Li ◽  
Joseph Beere ◽  
Chengquan Zhao
Keyword(s):  
Hpv 16 ◽  
Hpv Test ◽  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Akouélé P. Kuassi-Kpede ◽  
Essolakina Dolou ◽  
Théodora M. Zohoncon ◽  
Ina Marie Angèle Traore ◽  
Gnatoulma Katawa ◽  
...  

Abstract Background The causative agent of cervical cancer referred to as Human papillomavirus (HPV) remains a real public health problem. Many countries in West Africa, such as Togo have no data on the high-risk HPV (HR-HPV) infection and genotypes distribution. In order to fill the knowledge gap in the field in Togo, the main objective of this study was to determine the prevalence of pre-cancerous lesions of the cervix and HR-HPV genotypes among Togolese women. Methods Samples were collected from 240 women by introducing a swab in the cervix. Then, the screening of precancerous cervical lesions using the visual inspection with acetic acid and lugol (VIA / VIL) was conducted. The HR-HPV genotypes were characterised by real-time multiplex PCR. Results Out of 240 women recruited, 128 (53.3%) were infected by HR-HPV. The most common genotypes were HPV 56 (22.7%), followed by HPV 51 (20.3%), HPV 31 (19.5%), HPV 52 (18.8%) and HPV 35 (17.2%). The least common genotypes were HPV 33 (2.3%) and HPV 16 (2.3%). Among the women, 1.3% (3/240) were positive to VIA/VIL. Conclusion This study allowed HR-HPV genotypes to be characterised for the first time in Lomé, Togo. This will help in mapping the HR-HPV genotypes in West Africa.


Cells ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 714
Author(s):  
Matthias Läsche ◽  
Horst Urban ◽  
Julia Gallwas ◽  
Carsten Gründker

Cervical cancer is responsible for around 5% of all human cancers worldwide. It develops almost exclusively from an unsolved, persistent infection of the squamocolumnar transformation zone between the endo- and ecto-cervix with various high-risk (HR) human papillomaviruses (HPVs). The decisive turning point on the way to persistent HPV infection and malignant transformation is an immune system weakened by pathobionts and oxidative stress and an injury to the cervical mucosa, often caused by sexual activities. Through these injury and healing processes, HPV viruses, hijacking activated keratinocytes, move into the basal layers of the cervical epithelium and then continue their development towards the distal prickle cell layer (Stratum spinosum). The microbial microenvironment of the cervical tissue determines the tissue homeostasis and the integrity of the protective mucous layer through the maintenance of a healthy immune and metabolic signalling. Pathological microorganisms and the resulting dysbiosis disturb this signalling. Thus, pathological inflammatory reactions occur, which manifest the HPV infection. About 90% of all women contract an HPV infection in the course of their lives. In about 10% of cases, the virus persists and cervical intra-epithelial neoplasia (CIN) develops. Approximately 1% of women with a high-risk HPV infection incur a cervical carcinoma after 10 to 20 years. In this non-systematic review article, we summarise how the sexually and microbial mediated pathogenesis of the cervix proceeds through aberrant immune and metabolism signalling via CIN to cervical carcinoma. We show how both the virus and the cancer benefit from the same changes in the immune and metabolic environment.


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