| Objective:The aim of this study was to investigate the characteristics of morphological features, immunohistochemical expression and HPV infection in different subtypes of cervical adenocarcinoma.Methods:Paraffin blocks of690patients of cervical adenocarcinoma, cervical adenosquamous carcinoma and cervical neuroendocrine carcinoma treated in several hospitals in seven districts of China from year2005to year2010were collected.p16and PR immunostaining and HPV detecting by SPF-10PCR-DEIA-LiPA were conducted on all cases.142cases were conducted with laser capture microdissection technology to identify HPV infection in the tumour cells.Excel2007was used for data entering and SPSS20.0for statistical analysis. The descriptive analysis was used to state morphological information, distribution of HPV infenction, and the results of LCM; t-test was used to compare the two groups of measurement data; multiple groups of measurement data were compared with one-way ANOVA; chi-square test were used to compare count data. P-values<0.05were considered statistically significant.Results:1.690cases of patients contained571cases of cervical adenocarcinoma (82.8%),106cases of cervical adenosquamous carcinoma (15.4%) and13cases of cervical neuroendocrine carcinoma (1.9%). Cervical adenocarcinoma included378cases of endocervical adenocarcinoma (66.2%),51cases of endometrioid adenocarcinoma (8.9%),38cases of intestinal type adenocarcinoma (6.7%),32cases of minimal deviation adenocarcinoma (5.6%),30cases of clear cell adenocarcinoma (5.3%),16cases of serous adenocarcinoma (2.8%),13cases of villoglandular type adenocarcinoma (2.3%),9cases of signet ring cell adenocarcinoma (1.6%), and4cases of mesonephric adenocarcinoma (0.7%). Age differences among three kinds of cervical cancer is statistically significant (F=5.037, P<0.05); there was statistically significant age difference among different types of cervical adenocarcinoma (F=2.548, P<0.05).2. The positive rate of p16in690cases was75.8%; there were significant differences in the positive rate of p16in three cervical cancer (χ2=31.499, P<0.05);, the positive rate of p16in different subtypes of cervical adenocarcinoma also have significant difference (χ2=77.852, P<0.05). The positive rate of PR in690cases was11.2%; no statistically significant differences among the three kinds of cervical cancers in the positive rate of PR (χ2-1.876, P>0.05), while the positive rate of PR among different subtypes of adenocarcinoma has significant difference (χ2=295.441, P<0.05).96cases were stained by vimentin and the positive rate of vimentin in endometrioid adenocarcinoma was65%, much higher than other types, the difference was statistically significant (χ2=19.726, P<0.05)3. HPV infection rate in690cases was71.3%, and the age of HPV positive cases was lower than the HPV negative cases, and the difference was statistically significant (7=7.799, P<0.05); the infection rate of HPV in three types of cervical cancer had significant differences (χ2=29.443, P<0.05); HPV infection rates in different subtypes of cervical adenocarcinoma were also statistically significant (χ2=82.356, P<0.05). Among all subtypes of cervical adenocarcinoma, the age between HPV positive cases and negative cases was significiant different in endocervical adenocarcinoma and intestinal type adenocarcinoma, there was no significant difference in other subtypes of cervical adnocarcinoma.4. There were20cases with CIN including18cases of cervical adenocarcinoma and2cases of cervical neuroendocrine carcinoma.HPV infection rate was statistically significant different between CIN cases and cases without CIN (χ2=8.289, P<0.05). Among the HPV positive cases, the multiple HPV infection rate between CIN cases and cases without CIN is statistically different (χ2=4.805, P<0.05).5. The results of p16expression and HPV infection have relevance in adenosquamous carcinoma, endocervical adenocarcinoma and intiestinal type adenocarcinoma. Endometrioid adenocarcinoma, minimal deviation adenocarcinoma, clear cell adenocarcinoma and serous carcinoma do not have the relevance.6. Compared with the cervical endometrioid adenocarcinoma, there was a lower HPV infection rate of uterine endometrioid adenocarcinoma; the positive rate of both vimentin and PR between the two kinds of carcinoma has no statistical difference.7. LCM-PCR was performed on some HPV positive cases.50of51cases with multiple HPV infection were detected with only one HPV type or found no HPV infection; in44cases of special type adenocarcinoma, HPV wasn’t found in the tumor tissue in minimal deviation adenocarcinoma, endometrioid adenocarcinoma, serous adenocarcinoma and mesonephric adenocarcinoma. Only3cases of clear cell adenocarcinoma were HPV positive.Conclusions:1. The morphology of cervical adenocarcinoma is complicated and its HPV infection rate was lower than those of cervical squamous cell carcinomas.What’s more,its prepondrant HPV subtypes was different from that of squamous cell carcinomas.2. In HPV-related cervical cancer, p16staining can be used as evidence of HPV infection, while non-HPV-related cervical cancer, p16staining don’t prompted to HPV infection, there may be non-HPV-dependent p16expression mechanism.3. In some subtypes of cervical cancer, The age of onset in HPV-positive case is much lower than that of HPV-negative4. A group of antibody have some help in differential diagnosis between cervical endometrioid adenocarcinoma and other types of cervical cancer, but have no effect in distinguishing the primary site of endometrioid adenocarcinoma a.5. By performing LCM-PCR on some HPV positive cervical cancer, we detected that HPV wasn’t found in the tumor tissue in minimal deviation adenocarcinoma, endometrioid adenocarcinoma, serous adenocarcinoma and mesonephric adenocarcinoma. Only in a few of clear cell adenocarcinoma can we detect HPV infection. |
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