Unusual Morphological Types of Cervical Adenocarcinoma Are Not Associated with Human Papillomavirus Infection
OP Houghton, J Jamison, R Wilson, J Carson, WG McCluggage. Royal Group of Hospitals Trust, Belfast, Ireland; Antrim Area Hospital, Antrim, Ireland
Background: The association between human papillomavirus (HPV) and cervical carcinoma is well known with HPV being identifiable in almost all cervical squamous carcinomas and most adenocarcinomas. However, the prevalence of HPV in unusual morphological types of cervical adenocarcinoma has not been extensively investigated.
Design: We looked for HPV in a series of primary cervical adenocarcinomas, enriched for unusual morphological types. We also investigated the relationship between HPV and p16 immunoreactivity. 58 cervical adenocarcinomas, comprising those of usual type (n=42), minimal deviation type (n=4), gastric type (n=3), intestinal type (n=2), mesonephric type (n=2), clear cell type (n=4) and hepatoid type (n=1) underwent linear array HPV genotyping and immunohistochemical staining with p16.
Results: Overall, HPV was identified in 31 of 53 cases (58%) in which sufficient DNA was present for analysis. The most common HPV types were 16 and 18 with these being identified in 19 and 18 cases respectively, either alone or in combination. 78% of usual type adenocarcinomas were HPV positive. In contrast, all minimal deviation adenocarcinomas and those of gastric, intestinal, mesonephric and clear cell type were HPV negative, as was the single hepatoid carcinoma. All usual type adenocarcinomas exhibited p16 immunoreactivity (diffuse staining in all but one case), as did 9 of 15 of those of unusual morphological type (5 focal, 4 diffuse).
Conclusions: Most, but not all, cervical adenocarcinomas of usual type contain HPV but those of unusual morphological type are HPV negative. This has implications regarding the efficacy of HPV vaccination in the prevention of cervical adenocarcinoma. Although diffuse p16 staining in the cervix is regarded as a useful surrogate marker of the presence of high risk HPV, some adenocarcinomas of usual and unusual type are positive in the absence of HPV.
Category: Gynecologic & Obstetrics
Tuesday, March 23, 2010 9:30 AM
Poster Session III # 184, Tuesday Morning