Department of Pathology, University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, Targu Mures, Romania.
VCS Pathology, VCS Foundation, Carlton, Vic., Australia.
Adv Anat Pathol. 2020 Sep;27(5):278-293. doi: 10.1097/PAP.0000000000000266.
Modern classification schemes divide cervical adenocarcinomas into human papillomavirus (HPV)-associated and HPV-independent types. The precursor lesions of the former are well known and comprise HPV-associated (usual/endocervical) adenocarcinoma in situ (AIS) and the much less common stratified mucin-producing intraepithelial lesion (SMILE). The precursor lesions of HPV-independent cervical adenocarcinomas are much less well known, although postulated precursors of gastric-type adenocarcinoma include atypical lobular endocervical glandular hyperplasia and gastric-type AIS. In this review, we cover HPV-associated and HPV-independent precursor lesions of cervical adenocarcinomas concentrating on diagnostic criteria (morphology and immunophenotype) and differential diagnosis. We propose a uniform terminology and diagnostic criteria for precursor lesions showing intestinal differentiation with goblet cells because this may be a feature of both HPV-associated and HPV-independent AIS.
现代分类方案将宫颈腺癌分为人乳头瘤病毒（HPV）相关型和 HPV 非相关型。前者的前体病变众所周知，包括 HPV 相关（普通/宫颈）腺癌原位（AIS）和不太常见的分层黏液产生上皮内病变（SMILE）。HPV 非相关宫颈腺癌的前体病变则知之甚少，尽管推测胃型腺癌的前体包括非典型小叶宫颈腺增生和胃型 AIS。在这篇综述中，我们集中讨论了宫颈腺癌的 HPV 相关和 HPV 非相关前体病变，重点介绍了诊断标准（形态学和免疫表型）和鉴别诊断。我们提出了用于具有杯状细胞的肠型分化前体病变的统一术语和诊断标准，因为这可能是 HPV 相关和 HPV 非相关 AIS 的共同特征。
