Article (Scientific journals)
Intestinal-type endocervical adenocarcinoma in situ: an immunophenotypically distinct subset of AIS affecting older women.
Howitt, Brooke E.; Herfs, Michael; Brister, Kathriel et al.
2013In American Journal of Surgical Pathology, 37 (5), p. 625-33
Peer Reviewed verified by ORBi
 

Files


Full Text
Howitt intestinal type adenocarcinoma.pdf
Publisher postprint (745.09 kB)
Request a copy

All documents in ORBi are protected by a user license.

Send to



Details



Keywords :
Adenocarcinoma/metabolism/pathology/virology; Adult; Carcinoma in Situ/metabolism/pathology/virology; Female; HIV Protease; Humans; Immunohistochemistry; Ki-67 Antigen; Middle Aged; Papillomavirus Infections/epidemiology; Tumor Markers, Biological/analysis; Uterine Cervical Neoplasms/metabolism/pathology/virology
Abstract :
[en] Conventional endocervical adenocarcinoma in situ (cAIS) is typically strongly and diffusely positive for p16 with a high Ki67 index consistent with its frequent association with high-risk human papillomavirus (HPV) infection. The intestinal variant (iAIS) is less common, and its relationship to HPV infection has not been thoroughly examined. This study compares the clinicopathologic features, frequency of HPV infection, and expression of CDX2 and surrogate biomarkers of HPV infection (p16, Ki67) in cAIS with those of iAIS. A total of 86 cases with a diagnosis of AIS (49 iAIS, 37 cAIS) were identified from our multi-institutional files. Of these, 13 iAIS and 20 cAIS cases had slides and tissue available for histopathologic review, immunohistochemical analysis, and molecular tests. All 86 cases were used to evaluate clinical parameters; however, HPV DNA analysis and immunohistochemical analysis for p16, MIB-1, CDX2, and p53 were performed only on those cases with available slides or paraffin blocks. The average age at diagnosis was significantly higher in iAIS compared with that in cAIS (44.5 vs. 32.6 y) (P=0.0001). All 20 cAIS cases showed moderate to strong and diffuse p16 staining; however, only 9/13 iAIS cases showed this degree of p16 staining, whereas 4/13 (31%) iAIS cases showed weak and patchy distribution (P<0.02). Only 6/9 (67%) iAIS cases were positive for either HPV type 18 (5) or 33 (1), in contrast to 11/11 conventional cAIS (P=0.04). Similarly, 12/14 cAIS, but only 5/13 iAIS, cases showed a high Ki67 proliferative index. CDX2 was positive in all iAIS cases, whereas p53 was negative. Most iAIS cases are positive for high-risk HPV and show moderate to strong and diffuse p16 staining; however, a subset of iAIS shows variable staining with p16 and Ki67, is not associated with HPV, and occurs in a distinctly older age group suggesting an alternative pathogenesis. Awareness that iAIS can show variable staining for p16 and Ki67 is important when resolving problematic endocervical lesions, particularly in small biopsies with unusual p16 staining patterns.
Disciplines :
Oncology
Author, co-author :
Howitt, Brooke E.
Herfs, Michael ;  Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Anatomie et cytologie pathologiques
Brister, Kathriel
Oliva, Esther
Longtine, Janina
Hecht, Jonathan L.
Nucci, Marisa R.
Language :
English
Title :
Intestinal-type endocervical adenocarcinoma in situ: an immunophenotypically distinct subset of AIS affecting older women.
Publication date :
2013
Journal title :
American Journal of Surgical Pathology
ISSN :
0147-5185
eISSN :
1532-0979
Publisher :
Lippincott Williams & Wilkins, United States - New York
Volume :
37
Issue :
5
Pages :
625-33
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 09 January 2014

Statistics


Number of views
86 (3 by ULiège)
Number of downloads
1 (1 by ULiège)

Scopus citations®
 
27
Scopus citations®
without self-citations
24
OpenCitations
 
26

Bibliography


Similar publications



Contact ORBi