Cimic Adela, Liu-Jarin Xiaolin
Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY, United States.
Acta Med Acad. 2021 Apr;50(1):126-135. doi: 10.5644/ama2006-124.330.
In the present review, we summarize and critically appraise recent advances in the pathology of endocervical adenocarcinoma. In recent years, the diagnosis of endocervical adenocarcinoma has shifted from morphologic criteria classification in 2014 World Health Organization (WHO) to etiology- based classification of International endocervical adenocarcinoma criteria and classification (IECC). IECC recommends classifying endocervical adenocarcinoma into Human Papillomavirus (HPV)- associated and non-HPV-associated. Ultimately, this approach may lead to different treatment options based on molecular pathways rather than purely based on the tumor's grade and stage. Recently, the College of American Pathologists (CAP) has incorporated stromal invasion patterns as an optional data set in the synoptic report. The pattern of invasion classification is a valuable prognostic tool in excision specimens. CONCLUSION: IECC is a simple classification system that recognizes and classifies endocervical tumors based on pathogenesis and association to HPV. The pathologists should also be familiar with the pattern-based classification of endocervical adenocarcinoma.
在本综述中,我们总结并批判性地评估了宫颈管腺癌病理学的最新进展。近年来,宫颈管腺癌的诊断已从2014年世界卫生组织(WHO)的形态学标准分类转变为基于病因的国际宫颈管腺癌标准与分类(IECC)。IECC建议将宫颈管腺癌分为人乳头瘤病毒(HPV)相关型和非HPV相关型。最终,这种方法可能会根据分子途径而非单纯基于肿瘤的分级和分期导致不同的治疗选择。最近,美国病理学家学会(CAP)已将间质浸润模式作为概要报告中的一个可选数据集纳入。浸润模式分类在切除标本中是一种有价值的预后工具。结论:IECC是一个简单的分类系统,它基于发病机制和与HPV的关联来识别和分类宫颈管肿瘤。病理学家还应熟悉宫颈管腺癌基于模式的分类。