Lee Seung Jun, Lee Seokhyun, Nikas Ilias P, Kim Misong, Lee Maria, Kim Hee Seung, Chung Hyun Hoon, Kim Jae-Weon, Kim Haeryoung, Yun Sumi, Hwang Kyung-Ah, Kim Se Ik, Lee Cheol
Departments of Obstetrics and Gynecology.
Department of Obstetrics and Gynecology, Dankook University College of Medicine, Cheonan, Republic of Korea.
Am J Surg Pathol. 2025 Jul 1;49(7):701-710. doi: 10.1097/PAS.0000000000002391. Epub 2025 Mar 26.
This study aimed to investigate the impact of different histologic and high-risk (HR) human papillomavirus (HPV) types on the clinicopathologic characteristics and survival of patients with neuroendocrine carcinoma of the cervix (NEC). We retrospectively reviewed the medical records of patients with NEC diagnosed and treated at the Seoul National University Hospital between January 2000 and December 2021. Two pathologists specializing in gynecologic oncology thoroughly examined the slides. To determine the type of HPV infection, microarray analysis and next-generation sequencing were conducted. In addition, the impact of several variables on progressoin-free survival (PFS) and overall survival (OS) was investigated. In total, 47 patients with NEC were included in this analysis. Small-cell neuroendocrine carcinoma (SCNEC) and large-cell neuroendocrine carcinoma (LCNEC) were identified in 36 (76.6%) and 11 (23.4%) patients, respectively. Whereas 31 (66.0%) patients had a pure NEC, 16 (34.0%) were diagnosed with a mixed neuroendocrine non-neuroendocrine neoplasm (MiNEN). Of the 32 NEC patients whose HPV infection status was confirmed, HR-HPV infection was found in 30 of them (93.8%). Nineteen patients were infected with HPV 18. Between patients infected with HPV 16 or 18 and HR-HPV other than 16 or 18, there was no significant difference in most clinicopathologic characteristics such as histology ( P =0.311). However, HR-HPV type other than 16 or 18 was associated with pelvic lymph node metastasis ( P =0.044) and advanced stage ( P =0.035). In the Kaplan-Meier analysis and the Cox regression analyses, no significant difference in PFS and OS was observed between LCNEC and SCNEC, pure NEC and MiNEN, and HPV 16 or 18 and HR-HPV other than 16 or 18. High-risk HPV infection, especially from HPV 18, might play a role and impact on NEC pathogenesis. In this study, we did not find evidence that diverse histology and HR-HPV types affect PFS and OS.
本研究旨在探讨不同组织学类型及高危（HR）人乳头瘤病毒（HPV）类型对宫颈神经内分泌癌（NEC）患者临床病理特征及生存情况的影响。我们回顾性分析了2000年1月至2021年12月期间在首尔国立大学医院诊断并接受治疗的NEC患者的病历。两名妇科肿瘤专业病理学家对切片进行了全面检查。为确定HPV感染类型，进行了微阵列分析和二代测序。此外，还研究了多个变量对无进展生存期（PFS）和总生存期（OS）的影响。本分析共纳入47例NEC患者。其中，小细胞神经内分泌癌（SCNEC）和大细胞神经内分泌癌（LCNEC）分别有36例（76.6%）和11例（23.4%）。31例（66.0%）患者为纯NEC，16例（34.0%）被诊断为混合性神经内分泌-非神经内分泌肿瘤（MiNEN）。在32例HPV感染状态得到确认的NEC患者中，30例（93.8%）检测到HR-HPV感染。19例患者感染了HPV 18。在感染HPV 16或18的患者与感染16或18以外的HR-HPV的患者之间，在大多数临床病理特征（如组织学类型）方面无显著差异（P =0.311）。然而，16或18以外的HR-HPV类型与盆腔淋巴结转移（P =0.044）及晚期（P =0.035）相关。在Kaplan-Meier分析和Cox回归分析中，LCNEC与SCNEC、纯NEC与MiNEN、HPV 16或18与16或18以外的HR-HPV之间在PFS和OS方面均未观察到显著差异。高危HPV感染，尤其是HPV 18感染，可能在NEC发病机制中起作用并产生影响。在本研究中，我们未发现不同组织学类型及HR-HPV类型影响PFS和OS的证据。
