HPV Is Not an Etiological Agent of Adenosarcomas of the Cervix: A PCR-Based Study of Formalin-Fixed, Paraffin-Embedded Tissue
V Dube, MA Khalifa, S Nofech-Mozes, Z Ghorab, N Ismiil, P Sun, G Koultchitski, G Yang, A Seth, RS Saad. Sunnybrook Health Sciences Centre, Toronto, Canada
Background: Mullerian adenosarcomas are biphasic tumors composed of malignant stromal elements and benign epithelium that are mostly diagnosed in the endometrium. Rarely, adenosarcomas arise from the uterine cervix where little is known regarding their etiology. High-risk HPV is the etiological agents of most epithelial cervical cancers, but the association of HPV and cervical adenosarcomas remains unclear. We examined formalin-fixed paraffin-embedded tissue from primary cervical adenosarcomas for the presence of HPV viral DNA using PCR-based technology.
Design: In-house cases of cervical adenosarcomas accessioned between 2000 and 2009 were retrieved from the pathology archives. Adenosarcoma was diagnosed in the presence of periglandular stromal hypercellularity (cuffing), irregularly shaped glands with stromal budding (phyllodes-like pattern) and malignant stroma with atypia and mitoses (the range of atypia and mitotic activity was variable). HPV testing was performed with DNA extracted from deparaffinized sections of all cases using the Roche AMPLICOR® HPV Amplification Detection and Control Kits (Roche Molecular Systems, CA, USA), which enables detection of 13 high-risk HPV genotypes.
Results: Eight cases of cervical adenosarcomas were identified. One case showed sarcomatous overgrowth with subsequent recurrence and metastasis. In one case, the tumor involved both cervix and lower uterine segment; the case was included in the study because the bulk of the tumor was located in the cervix. PCR was successful in all 8 cases. High risk HPV DNA was not detected in any of the 8 cases.
Conclusions: Unlike in most cervical cancers, HPV infection does not appear to be a key risk factor in the carcinogenesis of cervical adenosarcomas, in keeping with the absence of epithelial dysplasia. We conclude that cervical adenosarcomas have a different carcinogenic pathway than that of most cervical cancers.
Category: Gynecologic & Obstetrics
Tuesday, March 23, 2010 9:30 AM
Poster Session III # 192, Tuesday Morning