Abstract
Objective: To investigate the relationship between micropapillary patten, cribriform pattern and retraction clefting of HPV associated endocervical adenocarcinoma and Silva classification and prognosis; and to validate the application and clinical significance of Silva system in endocervical adenocarcinoma. Methods: Cases of endocervical adenocarcinoma from January 2009 to November 2017 were selected from the Second Hospital of Jilin University and followed up. The morphologic characteristics of Silva classification, micropapillary patten, cribriform pattern and retraction clefting were observed and recorded. Inferential analysis was performed to compare clinicopathological variables data between pattern subgroups. Results: The study included 120 patients (ranging from 26 to 73 years) with an average age of (48.0±9.1)years. Silva A, B and C accounted for 9.2% (11/120), 18.3% (22/120) and 72.5% (87/120), respectively. Cases with micropapillary pattern accounted for 25.8%(31/120), of which six cases were Silva B and 25 cases were Silva C. Cases with cribriform pattern accounted for 53.3%(64/120), including three cases of Silva A, 17 cases of Silva B and 44 cases of Silva C. Retraction clefting occurred in 28.3%(34/120) cases, all were Silva C. The three morphologic features were associated with lymph node metastasis (P<0.05). Univariate analysis showed that micropapillary pattern was related to prognosis of endocervical carcinoma (P<0.05), while cribriform pattern, retraction clefting and Silva classification showed no correlation with overall survival and disease-free survival. Conclusions: The suggestion is revising the Silva C criteria by adding papillary patten and retraction clefting as factors and expanding the Silva pattern system to include more histologic variants. The Silva system is helpful to select appropriate operation before surgery, but its prognostic value requires further evaluation.
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Schedule a callMore From: Zhonghua bing li xue za zhi = Chinese journal of pathology
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