title: Pathological characteristics of cervical adenocarcinoma in a multi-center US-based study.
abstract: OBJECTIVE
  Difficulties in detecting cervical adenocarcinoma early are well known. We report a detailed pathology review of cervical adenocarcinoma subtypes, comparing growth patterns and appearance of non-neoplastic epithelium to inform possible clues for disease progression and early detection.
  
  
  METHODS
  This analysis includes 154 women aged 18-69 years and diagnosed with incident in situ or invasive adenocarcinoma (AC), adenosquamous (AS), or other rare cervical glandular tumors from 1992-1996 in six U.S. medical centers. A pathology review panel evaluated histological features from original diagnostic slides.
  
  
  RESULTS
  Higher tumor grade (P < 0.001) and vascular invasion (P = 0.002) were more common in AS compared to AC. Adenocarcinoma in situ (AIS) was also more common among AC than AS (P = 0.002). Among AC with cervical intraepithelial carcinoma (CIN), AIS and cribriform patterns were more common than AC without CIN (P = 0.01). Further, non-endometrioid AC had higher tumor grade (P = 0.01) and stromal responses (P = 0.02) than endometrioid AC. Finally, although microglandular hyperplasia is historically thought to be related to oral contraceptive (OC) use, our data do not support this notion.
  
  
  CONCLUSIONS
  AS appears to be either diagnosed later or histologically more aggressive than AC, and among AC subtypes, there are distinct histologic characteristics. Further research is needed to identify precursor lesions for early detection of AC and particularly for AS where AIS may not be a common precursor.
authors.affiliation: Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, Bethesda, MD 20852-7234, USA. wangso@mail.nih.gov
authors.forename: Sophia S
authors.initials: SS
authors.lastname: Wang
authors.forename: Mark E
authors.initials: ME
authors.lastname: Sherman
authors.forename: Steven G
authors.initials: SG
authors.lastname: Silverberg
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Carreon
authors.forename: James V
authors.initials: JV
authors.lastname: Lacey
authors.forename: Richard
authors.initials: R
authors.lastname: Zaino
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Kurman
authors.forename: Allan
authors.initials: A
authors.lastname: Hildesheim
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D018196:Carcinoma, Adenosquamous / Q000473:pathology; D018269:Carcinoma, Endometrioid / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000145:classification / Q000473:pathology*; D002578:Uterine Cervical Dysplasia / Q000473:pathology