Difficulties and possibilities of cytodiagnosis of origin of adenocarcinoma in cervical smears

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Abstract

BACKGROUND: The duration and accuracy of verification of origin and morphological variant of adenocarcinoma in the cervical smear affect the effectiveness of the treatment of patients. Currently, few publications on the possibility of clarifying the origin of adenocarcinoma in a cervical smear using the traditional cytological method are not sufficient for evidence-based conclusions.

AIMS: To identify patterns of cytological indicators of origin of adenocarcinoma in the biomaterial from the cervix.

MATERIALS AND METHODS: In an observational one-stage retrospective study, a comparative analysis of cytological tests of cervical smears with the conclusion “adenocarcinoma” was carried out with clinical and anamnestic information and the results of histological, immunohistochemical, molecular and genetic examinations. Information about 143 patients in the cancer registry of the Altai Regional Oncological Dispensary (Barnaul) for 2021 was used for analysis. Cytology preparations were prepared by the traditional method, as well as by the method of liquid cytology, staining was carried out by the Papanicolaou (Pap Test) and Pappenheim methods. Testing for human papillomavirus (HPV) was carried out by immunohistochemical method and polymerase chain reaction. PIK3CA and KRAS mutations were detected by polymerase chain reaction.

RESULTS: The cytological conclusion “adenocarcinoma” was confirmed by histology for all 143 women. There were cytology features of the morphological variant of AC, as well as to suggest the primary organ of adenocarcinoma, subsequently verified by visualization methods, histological, immunohistological examinations of biopsy and/or surgical material. The adenocarcinoma elements in the cervical smear was accompanied by adenocarcinoma in the endometrium, cervix, ovary/fallopian tube, colon (68.5, 17.6, 9.8 and 2.8% of cases, respectively; p <0.001). Differentiation of endometrial adenocarcinoma varied. Clear cell adenocarcinoma had specific cellular features. Cellular characteristics of HPV-associated and HPV-unassociated endocervical carcinomas differed from each other. Invasion of intestinal adenocarcinoma into the uterus and cervix was characterized by complexes with a “palisade” arrangement of cells in cervical smears.

CONCLUSION: Cytolodiagnostics of adenocarcinoma in smear from the cervix has prospects for further improvement in the verification of the organ origin of carcinoma. It is assumed that it is rational to assess associations of cytology with histo-, cytochemical, molecular and genetic characteristics of adenocarcinoma.

About the authors

Ol’ga G. Grigoruk

Altai Regional Oncological Dispensary; Altai State Medical University

Email: cytolakod@rambler.ru
ORCID iD: 0000-0001-9981-2348
SPIN-code: 7250-6259

Dr. Sci. (Biol.), Associate Professor

Russian Federation, Барнаул; Barnaul

Tat’jana A. Moskvina

Altai Regional Oncological Dispensary

Author for correspondence.
Email: tanhellita2010@bk.ru

MD

Russian Federation, Barnaul

Larisa M. Bazulina

Altai Regional Oncological Dispensary

Email: lardoc69@mail.ru
ORCID iD: 0000-0002-7222-0657

MD

Russian Federation, Barnaul

Sergej Ju. Bakharev

Altai Regional Oncological Dispensary

Email: bachero@mail.ru
Russian Federation, Barnaul

Elena Je. Pupkova

Altai Regional Oncological Dispensary

Email: elenapupkova@yandex.ru
Russian Federation, Barnaul

Svetlana A. Elchaninova

Altai State Medical University

Email: saelch@mail.ru
ORCID iD: 0000-0003-2730-615X
SPIN-code: 9015-4554

Dr. Sci. (Biol.), Professor

Russian Federation, Barnaul

References

  1. WHO classification of female genital tumours (Vol. 4), 5th edition. Lyon: International Agency for Research on Cancer; 2020. 631 p.
  2. Curty G, de Carvalho PS, Soares MA. The role of the cervicovaginal microbiome on the genesis and as a biomarker of premalignant cervical intraepithelial neoplasia and invasive cervical cancer. Int J Mol Sci. 2019;21(1):222. doi: 10.3390/ijms21010222
  3. Hohlova SV, Kolomiec LA, Kravec OA, i dr. Prakticheskie rekomendacii po lekarstvennomu lecheniju raka shejki matki. Malignant tumors. 2019;9(3s2):203–217. (In Russ). doi: 10.18027 / 2224-5057-2019-9-3s2-203-217
  4. Rogovskaya SI, Shabalova IP, Mikheeva IV, et al. Human papillomavirus prevalence and type-distribution, cervical cancer screening practices and current status of vaccination implementation in Russian Federation, the Western countries of the former Soviet Union, Caucasus region and Central Asia. Vaccine. 2013;31(suppl. 7):H46–H58. doi: 10.1016/j.vaccine.2013.06.043
  5. Ren H, Almadani N, Pors J, et al. International endocervical adenocarcinoma criteria and classification (IECC). International Journal of Gynecological Pathology. 2021;40(6):533–540. doi: 10.1097/PGP.0000000000000764
  6. Stolnicu S, Park KJ, Kiyokawa T, et al. Tumor typing of endocervical adenocarcinoma: contemporary review and recommendations from the international society of gynecological pathologists. International Journal of Gynecological Pathology. 2021;40(2):S75–S91. doi: 10.1097/PGP.0000000000000751
  7. Hodgson A, Park KJ, Djordjevic B, et al. International endocervical adenocarcinoma criteria and classification: validation and interobserver reproducibility. Am J Surg Pathol. 2019;43(1):75–83. doi: 10.1097/PAS.0000000000001095
  8. Sidoruk AA, Ul’rih EA, Novik VI, Urmancheeva AF. Trudnosti diagnostiki adenokarcinomy in situ shejki matki. Siberian journal of oncology. 2009;(S1):177–178. (In Russ).
  9. Grigoruk OG, Cherdantseva TM, Моskvina TA, et al. Evaluated possibility of adenocarcinoma diagnostics under the cytological method by the uterine cervix material. Tumors of female reproductive system. 2016;12(2):52–59. (In Russ). doi: 10.17650/1994-4098-2016-12-2-52-59
  10. Yemelyanova A, Vang R, Seidman JD, et al. Endocervical adenocarcinomas with prominent endometrial or endomyometrial involvement simulating primary endometrial carcinomas: utility of HPV DNA detection and immunohistochemical expression of p16 and hormone receptors to confirm the cervical origin of the corpus tumor. Am J Surg Pathol. 2009;33(6):914–924. doi: 10.1097/PAS.0b013e3181971fdd
  11. Biskup E, Wils RS, Hogdall C, Hogdall E. Prospects of improving early ovarian cancer diagnosis using cervical cell swabs. Anticancer Res. 2022;42(1):1–12. doi: 10.21873/anticanres.15451
  12. Suzuki M, Suzuki T, Matsuura M, et al. Prediction of histologic type and lymph node metastasis for advanced ovarian cancer on uterine cervical and endometrial cytology. Acta Cytol. 2010;54(4):575–581. doi: 10.1159/000325180
  13. Shintaku M, Taniguchi H, Yamamoto Y, et al. Detection of tumor cells of serous tubal intraepithelial carcinoma (STIC) in cervical smears and rapid development of the ovarian involvement: a case report. Diagn Cytopathol. 2018;46(11):945–949. doi: 10.1002/dc.23957
  14. Xu Y, Liu B, Zhang X, Chen L. Cytological features of ovarian or tubal high-grade serous carcinoma: a retrospective study of 12 cases with abnormal cervical liquid-based smear. Diagn Cytopathol. 2021;49(11):1207–1212. doi: 10.1002/dc.24871
  15. Kumar N, Bongiovanni M, Molliet MJ, et al. Diverse glandular pathologies coexist with high-grade squamous intraepithelial lesion in cyto-histological review of atypical glandular cells on ThinPrep specimens. Cytopathology. 2009;20(6):351–358. doi: 10.1111/j.1365-2303.2008.00568.x
  16. Jones R, Dale F, Fite JJ, et al. Endocervical glandular involvement is associated with an increased detection rate of high-grade squamous intraepithelial lesions on the Papanicolaou test. J Am Soc Cytopathol. 2020;9(3):137–145. doi: 10.1016/j.jasc.2019.12.004
  17. Lashmanova N, Braun A, Cheng L, et al. Endocervical adenocarcinoma in situ-from Papanicolaou test to hysterectomy: a series of 74 cases. J Am Soc Cytopathol. 2022;11(1):13–20. doi: 10.1016/j.jasc.2021.08.002

Supplementary files

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2. Fig. 1. Cytological preparation of a cervical smear: moderately differentiated endometrioid adenocarcinoma; glandular tumor structures. Pappenheim staining, ×400.

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3. Fig. 2. Cytological preparation of a cervical smear: clear cell adenocarcinoma of the endometrium; сells with light optically transparent cytoplasm and oxyphilic extracellular substance in a round cluster. Pappenheim staining, ×400.

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4. Fig. 3. Cytological preparation of a cervical smear: endocervical adenocarcinoma in situ associated with human papillomavirus; a group of tumor cells with signs of glandular differentiation. Pappenheim staining, ×400.

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5. Fig. 4. Cytological preparation of a cervical smear: endocervical adenocarcinoma in situ associated with human papillomavirus. The preparation was prepared by the method of liquid cytology. Papanicolaou staining, ×200.

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6. Fig. 5. Cytological preparation of a cervical smear: endocervical adenocarcinoma of the mesonephric type, independent of the human papillomavirus. Large cells with eccentric nuclei, abundant basophilic cytoplasm. Pappenheim staining, ×1000.

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7. Fig. 6. Cytological preparation of a cervical smear: serous adenocarcinoma of the ovary; glandular cell complexes of polymorphic cells. Pappenheim staining, ×400.

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8. Рис. 7. Цитологический препарат из материала с шейки матки: аденокарцинома кишечного типа; клеточные комплексы с «частокольным» расположением клеток. Окрашивание по Паппенгейму, ×40.

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Copyright (c) 2023 Grigoruk O.G., Moskvina М.A., Bazulina L.M., Bakharev S.J., Pupkova E.J., Elchaninova S.A.

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
 


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