A Clinicopathologic Study of Glandular Dysplasia of the Cervix

Casper, Gabrielle R.; Östör, Andrew G.; Quinn, Michael

doi:10.1006/gyno.1996.4528

Cited by 36 publications

(14 citation statements)

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“…Alternatively, the difference in ACIS with and without a squamous dysplasia may reflect a decline over time in the level of detail of histopathological reporting. In this study, 57% of ACIS lesions had a concurrent squamous dysplasia, a proportion according with other studies (Colgan and Lickrish, 1990;Anciaux et al, 1997;Casper et al, 1997;Bekkers et al, 2003). The decrease in ACIS incidence was mostly seen in the 15 -29 and 45 -59 years age groups, the former outside the ages of 30 -60 years in the screening programme in the Netherlands.…”

Section: Discussionsupporting

confidence: 82%

Significant decrease of adenocarcinoma in situ not reflected in cervical adenocarcinoma incidence in the Netherlands 1989–2003

et al. 2008

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Section: Discussionsupporting

confidence: 82%

Significant decrease of adenocarcinoma in situ not reflected in cervical adenocarcinoma incidence in the Netherlands 1989–2003

et al. 2008

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“…9 Widrich et al reported that 19 of 45 cases of adenocarcinoma in situ (42%) had glandular abnormality on smear test, 30 while Casper et al reported that only 23% of low grade CGIN were screen detected. 21 As in previous reports, 5 32 a significant proportion of our cases (30% of L-CGIN, 24% of H-CGIN, and 7% of invasive adenocarcinoma) were discovered incidentally at loop excision for CIN or at hysterectomy for benign lesions. Squamous abnormality on cervical smears may often overshadow coexisting glandular lesions.…”

Section: Discussionsupporting

confidence: 78%

“…It has also been suggested that women with L-CGIN are at increased risk of further preinvasive glandular changes in the genital tract. [19][20][21] Another diYculty concerning glandular neoplasia of the cervix is the controversial terminology of microinvasive adenocarcinoma, its natural history, and its histological recognition. 6 22 23 The few reports that have recently appeared regarding microinvasive adenocarcinoma have defined the tumour as invading up to 5 mm from the surface of the lesion and to have an excellent prognosis, similar to its squamous counterpart.…”

mentioning

confidence: 99%

Relation of cervical glandular intraepithelial neoplasia to microinvasive and invasive adenocarcinoma of the uterine cervix: a study of 121 cases.

Kurian

Al‐Nafussi

1999

J Clin Pathol

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Aims-To examine the relation between invasive adenocarcinoma and its alleged precursor, cervical glandular intraepithelial neoplasia (CGIN), and to assess the management and outcome of CGIN and the validity of using the term "microinvasive adenocarcinoma." Methods-The clinical and pathological features of 121 cases of glandular neoplasia of the cervix diagnosed between the years 1990 to 1995 were examined for the following: histological diagnosis, smear records, type of treatment, the association between the precursor lesions and invasive disease, and follow up. 1999;52:112-117) Results-27 cases were identified as low grade CGIN (L-CGIN) and 38 as high grade CGIN (H-CGIN

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“…71 73 The premalignant potential of high grade CGIN (adenocarcinoma in situ) is not in doubt, but the true natural history of low grade CGIN remains uncertain. CGIN often co-exists with squamous CIN 74 and for this reason may sometimes be overlooked. Abnormalities of oncoprotein expression have been demonstrated in CGIN.…”

Section: Neoplasiamentioning

confidence: 99%

Aetiology, pathogenesis, and pathology of cervical neoplasia.

1998

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Early epidemiological studies of cervical neoplasia suggested a causal relation with sexual activity and human papillomaviruses (HPVs) have emerged as prime suspects as venerally transmitted carcinogens. HPVs fall into two broad camps: low risk types, associated with cervical condylomas and CIN 1; and high risk types (mostly 16 and 18), found in 50-80% of CIN 2 and CIN 3 lesions, and 90% of cancers. This association with cancer is very strong, with odds ratios of > 15 (often much higher) in case-control studies that are methodologically sound. An infrequently detected third group of intermediate risk type HPVs is associated with all grades of CIN and occasionally with cancers. HPVs have also been detected in a wide range of asymptomatic controls, indicating that other events are required for development of neoplasia such as viral persistence and/or altered expression of viral genes, often following integration of the viral genome. This leaves the two major viral oncogenes, E6 and E7, directly coupled to viral enhancers and promoters, allowing their continued expression after integration. High risk HPV E7 proteins bind and inactivate the Rb protein, whereas E6 proteins bind p53 and direct its rapid degradation. A range of putative cofactors has been implicated in progression: HLA type, immunosuppression, sex steroid hormones, and smoking; most of these cofactors appear to influence progression to CIN 3. The natural history includes progression to CIN 3 in 10% of CIN 1 and 20% of CIN 2 cases, whereas at least 12% of CIN 3 cases progress to invasive carcinoma. Cervical glandular intraepithelial neoplasia (CGIN) often coexists with squamous CIN, and the premalignant potential of high grade CGIN is not in doubt, but the natural history of low grade CGIN remains uncertain. A high proportion of CGIN lesions and adenocarcinomas are HPV positive, and HPV18 has been implicated more in glandular than in squamous lesions. A strong clinical case for the application of HPV typing of cells recovered from cervical scrapes can be made; however, a rigorous cost-benefit analysis of introducing HPV typing into the cervical screening programme is required. Prophylactic and therapeutic HPV vaccines are under development. This article reviews the aetiology, pathogenesis, and pathology of cervical neoplasia, emphasising the role of HPVs. (J Clin Pathol 1998;51:96-103) Keywords: human papillomavirus; cervical neoplasia This review is based on three presentations by the authors to the first National Cervical Screening Conference organised by Marie Curie Cancer Care and held in Oxford, UK in September 1996. It also includes several more recent developments. It is important to emphasise that the cervical screening programme aims to detect women who have an epithelial abnormality that might, if untreated, lead to the development of cervical carcinoma. The screening programme is not designed to detect small or early invasive carcinomas, but no screening system will detect all women at risk and it is inevitable that in a small prop...

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A Clinicopathologic Study of Glandular Dysplasia of the Cervix

Cited by 36 publications

References 0 publications

Significant decrease of adenocarcinoma in situ not reflected in cervical adenocarcinoma incidence in the Netherlands 1989–2003

Significant decrease of adenocarcinoma in situ not reflected in cervical adenocarcinoma incidence in the Netherlands 1989–2003

Relation of cervical glandular intraepithelial neoplasia to microinvasive and invasive adenocarcinoma of the uterine cervix: a study of 121 cases.

Aetiology, pathogenesis, and pathology of cervical neoplasia.

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