[Cervical glandular intraepithelial neoplasia topography and the risk of conisation].

Abstract

OBJECTIVES: The frequency of endocervical adenocarcinoma is increasing in comparison with squamous cell carcinoma and it presents a very difficult diagnostic and therapeutic problem. DESIGN: The aim of this study was: 1) Evaluation of topography of the cervical glandular intraepithelial neoplasia (CGIN) 2) An analysis of the Human Papillomavirus (HPV) infection rate in samples. MATERIALS AND METHODS: 360 amputated uterine cervix samples with histologically-proven diagnosis of cervical intraepithelial neoplasia (CIN-3) were evaluated. The coexistence of pre-invasive lesions in squamous epithelium and endocervical columnar cell were investigated. Moreover CGIN topography and retrospective histopathological analysis were determined. A polymerase chain reaction (PCR) was performed using commercially available PCR Human Papillomavirus Typing Set to detect HPV infection. RESULTS: Among 360 positive cervical intraepithelial glandular neoplasia samples (CIN-3) 71 (19.7%) showed coexisting glandular lesions (CGIN-1, 2, 3). The lesions in endocervical glandular cells of CIGN-type were distributed from the distance up to 14 mm from the surface of cervix. Most of them were located no deeper than 1 mm from the surface of canal epithelium. HPV DNA was found in more than 90 preneoplastic glandular proliferations. The frequency of oncogenic HPV-16 and 18 presence was higher than non-oncogenic HPV. CONCLUSIONS: 1. CIN-3 is associated in about 20% with cervical glandular intraepithelial neoplasia (CGIN). 2. Topography of CGIN is important in planning the management. 3. Most of CIGN are associated with HPV infection.