Tumoral Morphologic Features From Cervical Biopsies That Are Predictive of a Negligible Risk for Nodal Metastasis and Tumor Recurrence in Usual-type Cervical Adenocarcinomas
| Autor: | Aijun Liu, Li-Li Liu, Jayanthi S. Lea, Yan Wang, Steven Holloway, Jun Wang, Oluwole Fadare, M.R. Quddus, Ming Li, Feng Zhou, Ruby Chang, Xiujie Sheng, Yun Wang, Natalie Banet, Huiting Zhu, Xiaofei Zhang, Beihua Kong, Yue Wang, J. Li, Ruijiao Zhao, Wanrun Lin, Rongzhen Luo, Rui Bi, Yan-Lin Wen, Qingping Jiang, Jihong Liu, Hao Chen, Glorimar Rivera, Wentao Yang, Yiying Wang, Xianghong Yang, Wenxin Zheng, Li Li, C.J. Sung, Yafei Qi, Jing Yu |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Lymphovascular invasion Biopsy Uterine Cervical Neoplasms Adenocarcinoma Gastroenterology Pathology and Forensic Medicine Stromal Invasion Internal medicine Eosinophilic medicine Humans Stage (cooking) Papillomaviridae medicine.diagnostic_test business.industry Carcinoma Odds ratio Confidence interval Cohort Female Surgery Neoplasm Recurrence Local Anatomy business |
| Zdroj: | American Journal of Surgical Pathology. 46:713-724 |
| ISSN: | 0147-5185 |
| Popis: | The metastatic or recurrent potential of localized human papillomavirus-associated endocervical adenocarcinoma (HPVA EAC) is difficult to predict, especially based upon biopsy alone. Recent analyses of small cohorts indicate that high tumor nuclear grade (TNG) and the presence of necrotic tumor debris (NTD) from HPVA EACs in cervical biopsy specimens are highly predictive of nodal metastasis (NM). In the present study, we aimed to investigate how reliably tumoral morphologic features from cervical biopsy specimens predict NM or tumor recurrence (TR) and patient outcomes in a large cohort of endocervical adenocarcinoma patients. A cohort comprised of 397 patients with HPVA EAC treated at 18 institutions was identified, and cervical biopsies were paired with their associated complete tumor resections for a total of 794 specimens. A variety of tumoral histologic features were examined for each paired specimen, including TNG (assessed on a 3-tiered scale of increasing abnormalities-TNG1, TNG2, TNG3) and NTD (defined by the presence of necrotic and apoptotic tumor cells within tumor glandular lumens admixed with granular and eosinophilic amorphous material and inflammatory cells), which were correlated with outcomes. The distribution of TNG in biopsies was as follows: 86 (21.7%) TNG1, 223 (56.2%) TNG2, and 88 (22.2%) TNG3. NTD was identified in 176 (44%) of the biopsy specimens. The sensitivity, specificity, positive predictive value, and negative predictive value of a TNG1 assignment in the biopsy being predictive of the same assignment in the full resection were 0.82 (95% confidence interval [CI]: 0.7-0.9), 0.895 (0.86-0.93), 0.593 (0.48-0.696), and 0.96 (0.94-0.98), respectively. Respective values for an NTD-negative status were 0.89 (95% CI: 0.83-0.92), 0.715 (0.64-0.77), 0.72 (0.65-0.77), and 0.89 (0.83-0.93), respectively. Compared with the other cases in each category, both TNG1 and an NTD-negative status were each significantly associated with lower rates of NM (odds ratio for TNG1=0.245, 95% CI: 0.070-0.857, P=0.0277; for NTD=0.199, 95% CI: 0.094-0.421, P |
| Databáze: | OpenAIRE |
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