Adenocarcinoma of the uterine cervix: prognostic significance of clinicopathologic parameters, flow cytometry analysis and HPV infection.
BACKGROUND
This study was designed to determine the possible impact of status of human papillomavirus (HPV) infection (no infection, single, multiple infections) on the survival of patients with cervical adenocarcinoma, to correlate the HPV status with other clinicopathologic parameters, and to examine clinical, histological and flow cytometric parameters as predictors of survival in cervical adenocarcinoma.


METHODS
The clinical data of 51 patients with adenocarcinoma of the cervix who were treated at the Department of Gynecology and Obstetrics, Zagreb University School of Medicine, from 1978 to 2004 were analysed: age at presentation, menstrual status, clinical stage, relapse, survival. Exact histologic subtype, architectural grade and nuclear grade were determined. DNA flow cytometry was performed to determine DNA ploidy and proliferative index. Polymerase chain reaction (SPF primers), followed by reverse hybridisation for genotyping, was used to determine the HPV status.


RESULTS
The status of HPV infection had no impact on patient survival, and could not be correlated with any of the analysed clinicopathologic parameters. Univariate analysis showed significant association between patient survival and clinical stage (p=0.002) and architectural grade (p=0.033). Multivariate analysis confirmed both parameters as significantly associated with survival. Menstrual status, nuclear grade, DNA ploidy and proliferative activity had no impact on patient survival.


CONCLUSIONS
Clinical stage and architectural grade are significant predictors for survival of patients with cervical adenocarcinoma. Status of HPV infection, flow cytometric parameters, nuclear grade and menstrual status do not predict patient survival.
Dabić
Mirela M
MM
Department of Pathology, Clinical Hospital Center Zagreb, Zagreb, Croatia.
Nola
Marin
M
Tomicić
Ivana
I
Dotlić
Snjezana
S
Petrovecki
Marko
M
Jukić
Stanko
S
D000230:Adenocarcinoma / Q000473:pathology* / Q000821:virology*; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D005434:Flow Cytometry; D006651:Histocytochemistry; D006801:Humans; D053208:Kaplan-Meier Estimate; D009367:Neoplasm Staging; D027383:Papillomaviridae / Q000235:genetics / Q000254:growth & development*; D030361:Papillomavirus Infections / Q000150:complications* / Q000473:pathology / Q000821:virology; D011003:Ploidies; D011379:Prognosis; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000821:virology*
D004279:DNA, Viral