Gastric-type adenocarcinoma of the cervix: Clinical outcomes and genomic drivers

Ehmann, Sarah; Sassine, Dib; Straubhar, Alli M.; Praiss, Aaron; Aghajanian, Carol; Alektiar, Kaled M.; Broach, Vance; Cadoo, Karen A.; Jewell, Elizabeth L.; Boroujeni, Amir Momeni; Kyi, Chrisann; Leitao, Mario M.; Mueller, Jennifer J.; Murali, Rajmohan; Bhaloo, Shirin Issa; O’Cearbhaill, Roisin E.; Park, Kay J.; Sonoda, Yukio; Weigelt, Britta; Zamarin, Dmitriy; Abu‐Rustum, Nadeem R.; Friedman, Claire F.

doi:10.1016/j.ygyno.2022.10.003

Cited by 10 publications

(11 citation statements)

References 35 publications

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“…A unique clinical aspect of GAS is the potential presence of metastases to the ovaries, peritoneal surface, and intraabdominal organs. 5 In this study, ovarian metastases were observed.…”

Section: Discussionmentioning

confidence: 68%

“…11 Approximately 5-15% of GASs are HER2amplified, and patients with ERBB2 alterations treated with the anti-HER2 antibody trastuzumab have excellent clinical outcomes. 5 In terms of novel agents, genome-wide analysis using next-generation sequencing (NGS) has identified several new molecular targets. However, there are few data on the efficacy and treatment of gastric adenocarcinoma based on sequencing results.…”

Section: Dovepressmentioning

confidence: 99%

“…3 GAS has been reported to be aggressive and insensitive to chemical therapy and to have a poorer survival outcome than usual endocervical-type adenocarcinoma (UEA). 4,5 Cervical squamous cell carcinomas and precancerous lesions are associated with high-risk human papilloma virus (HPV) infection. However, GAS is not related to HPV.…”

Section: Introductionmentioning

confidence: 99%

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A Case Study of Gastric Adenocarcinoma and Squamous Cell Carcinoma of the Cervix

Liu,

Li,

Cao

et al. 2024

OTT

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Gastric adenocarcinoma (GAS) is a rare subtype of mucinous adenocarcinoma characterized by gastric differentiation and is unrelated to human papillomavirus (HPV) infection. This report discusses a 40-year-old female who presented with abdominal distension accompanied by increased abdominal circumference. CT of the abdomen and pelvis showed a large 21.0*12.7*26.0 cm mass later diagnosed as GAS combined with squamous cell carcinoma on surgical pathology. Immunohistological staining of GAS was positive for CK7, MUC6, PAX-8 CEA, and P53 (wild type) and negative for CDX2, CK20, ER, PR, P16, and WT1. The proliferative index (Ki-67) was 20%. Immunohistochemical staining of squamous cell carcinoma was positive for P16 and P53 (wild type), and the proliferative index (Ki-67) was 90%. However, the pathogenesis and molecular mechanisms of GAS have not been fully elucidated. As more cases are identified and reported, additional targeted therapies can be developed and tested in these patients.

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“…A unique clinical aspect of GAS is the potential presence of metastases to the ovaries, peritoneal surface, and intraabdominal organs. 5 In this study, ovarian metastases were observed.…”

Section: Discussionmentioning

confidence: 68%

Section: Dovepressmentioning

confidence: 99%

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A Case Study of Gastric Adenocarcinoma and Squamous Cell Carcinoma of the Cervix

Liu,

Li,

Cao

et al. 2024

OTT

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“…While certain studies have indicated a limited occurrence of malignant transformation in LEGH 10,13 , it is crucial to acknowledge the elevated risk and poor prognosis of G-EAC in PJS patients. [4][5][6][7][8][9]15,16 So we recommend that individuals classi ed as Grade 1 and 2 opt for imaging surveillance at intervals of every 6 to 12 months for follow-up. For Grade 3, in whom imaging is insu cient to determine the nature of the lesions, we recommend obtaining a precise pathological diagnosis for more frequent follow-up or subsequent intervention.…”

Section: Mri Grading Criteria To Guide Clinical Decision-makingmentioning

confidence: 99%

MRI grading for informed clinical decision-making in Peutz-Jeghers syndrome patients with cervical lesions

Jiang,

Chen,

Ning

et al. 2023

Preprint

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Objective: The preoperative diagnosis and management of Peutz-Jeghers syndrome (PJS) patients with cervical lesions remains problematic. This study analyzed the associations between pathological types of cervical lesions in PJS patients and their imaging features, aiming to grade the potential malignancy and provide recommendations for clinical decision-making accordingly. Methods: A total of 34 PJS patients who attended the Obstetrics and Gynecology Hospital of Fudan University from October 2017 to August 2023 were included. Two experienced physicians reviewed their MRIs independently. Results: Based on pathological diagnosis, the patients were categorized into four groups: normal (n = 4), lobular endocervical glandular hyperplasia (LEGH, n = 11), atypical lobular endocervical glandular hyperplasia (aLEGH, n = 8), and gastric-type endocervical adenocarcinoma (G-EAC, n = 11). The mean age of 34 patients was 33.2 ± 8.4 years. Increased vaginal discharge was very common (20/34) and significant difference was observed among the four groups (P = .004). Through observing imaging features, we found statistically significant differences in the extent of lesions (P = .001), distribution of microcysts (P = .001), proportion of microcysts (P < .001) and endometrium invasion (P = .019) among the four groups. Notablely, the solid components and disrupted cervical stromal ring were only found within the aLEGH and G-EAC groups (P < .001). We proposed grading criteria to re-diagnose their images, with an overall consistency rate of 94.1% (32/34). Finally, we applied our grading criteria and corresponding clinical decisions to 2 PJS patients who had not yet undergone biopsy. Conclusions: We used MRI to grade the potential malignancy of cervical lesions and proposed appropriate management recommendations for PJS patients, which facilitated the collaboration between radiologists and physicians.

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“…Unfortunately, immune checkpoint inhibitors, which have been shown to have therapeutic effects in cervical cancer, may not be as effective. In the MSKCC study, the tumor mutational burden in 70 cases of GAS was 7, with a median of 3 54 …”

Section: Introductionmentioning

confidence: 99%

Current status and molecular biology of human papillomavirus‐independent gastric‐type adenocarcinoma of the cervix

Nishio

2023

J of Obstet and Gynaecol

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This article reviews the findings of clinical studies on gastric-type adenocarcinoma of the cervix to date, outline the molecular biological features identified in recent studies, and discusses the future therapeutic strategies. Gastric-type adenocarcinoma of the cervix is a new classification in the World Health Organization 2014 classification. The World Health Organization 2020 classification further divides cervical tumors into two categories: human papillomavirus-associated and human papillomavirus-independent. Thus, gastric-type adenocarcinoma of the cervix is now classified as a human papillomavirus-independent gastric type. Clinical studies have reported that gastric adenocarcinoma of the cervix is refractory to conventional chemotherapy and radiotherapy, and it is desirable to elucidate its molecular biological mechanism. A series of gene mutations characteristic to the gastric-type adenocarcinoma of the cervix encourage the development of future treatment strategies. K E Y W O R D Sgene mutation, HPV-independent gastric-type adenocarcinoma of the cervix, molecular biological features

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Gastric-type adenocarcinoma of the cervix: Clinical outcomes and genomic drivers

Cited by 10 publications

References 35 publications

A Case Study of Gastric Adenocarcinoma and Squamous Cell Carcinoma of the Cervix

A Case Study of Gastric Adenocarcinoma and Squamous Cell Carcinoma of the Cervix

MRI grading for informed clinical decision-making in Peutz-Jeghers syndrome patients with cervical lesions

Current status and molecular biology of human papillomavirus‐independent gastric‐type adenocarcinoma of the cervix

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