title: Detection of occult endocervical glandular dysplasia in cervical conization specimens for squamous lesions.
abstract: The aim of this work was to evaluate the incidence of occult cervical glandular intraepithelial neoplasia (CGIN) and adenocarcinoma of the cervix (AC) in women treated with CO2-laser conization for cervical intraepithelial neoplasia (CIN) or squamocellular cervical cancer (SCC). The medical records of all women with a histological diagnosis of squamous lesions of the uterine cervix (persistent CIN1, CIN2, CIN3 and SCC) who were subsequently treated with CO2-laser conization at our institution, during the period from January 1991 to December 2014, were analyzed in a retrospective case series. Among the 1004 women fulfilling the study inclusion/exclusion criteria, 77 cases (7.7%) of occult glandular lesions (CGIN and AC) were detected on the final cone specimen (48 cases of occult low-grade cervical glandular intraepithelial neoplasia (LCGIN), 25 cases of occult high-grade cervical glandular intraepithelial neoplasia (HCGIN), and four cases of occult "usual-type" AC). No difference in the mean age between women diagnosed with occult glandular lesions and women without occult glandular lesions on the final specimen emerged (39.1±9.3 vs 38.4±9.4, p=0.5). In women with occult LCGIN on cone specimen, mean follow-up of 48 months was reported (range 7-206 months) and no cases of progression to HCGIN or AC were observed. In conclusion, a relatively high rate of occult glandular lesions was found in women treated for squamous lesions. The natural history of CGIN is still uncertain and, in particular, there are some controversies as to whether LCGIN is a precursor lesion of HCGIN or AC. In this context the role of pathologists become very important since the appropriate diagnosis of these lesions could have potential implications in the clinical management of these patients.
authors.affiliation: Gynecological Oncology Unit, Centro di Riferimento Oncologico, National Cancer Institute, Via F. Gallini 2, 33081, Aviano, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Sopracordevole
authors.affiliation: Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Via F. Corridoni 11, 60123, Ancona, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Clemente
authors.affiliation: Pathology Unit, Centro di Riferimento Oncologico, National Cancer Institute, Via F. Gallini 2, 33081, Aviano, Italy. Electronic address: lara.alessandrini@cro.it.
authors.forename: L
authors.initials: L
authors.lastname: Alessandrini
authors.affiliation: Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Via F. Corridoni 11, 60123, Ancona, Italy.
authors.forename: J
authors.initials: J
authors.lastname: Di Giuseppe
authors.affiliation: Gynecological Oncology Unit, Centro di Riferimento Oncologico, National Cancer Institute, Via F. Gallini 2, 33081, Aviano, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Cigolot
authors.affiliation: Gynecological Oncology Unit, Centro di Riferimento Oncologico, National Cancer Institute, Via F. Gallini 2, 33081, Aviano, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Buttignol
authors.affiliation: Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Via F. Corridoni 11, 60123, Ancona, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ciavattini
authors.affiliation: Pathology Unit, Centro di Riferimento Oncologico, National Cancer Institute, Via F. Gallini 2, 33081, Aviano, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Canzonieri
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D002584:Cervix Uteri / Q000473:pathology* / Q000601:surgery; D003127:Colposcopy; D019092:Conization; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008875:Middle Aged; D011230:Precancerous Conditions / Q000473:pathology* / Q000601:surgery; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000473:pathology* / Q000601:surgery
keywords: Adenonocarcinoma (AC); Cervical glandular intraepithelial neoplasia (CGIN); Conization; Occult cervical glandular lesions