Endocervical adenocarcinoma. Clinico-pathologic and histochemical study of 29 cases.

Twenty-nine women were treated for endocervical adenocarcinoma in the University of Bari in the years 1975-1981. The histological type was "endocervical" or "mucinous" in 12 patients (41.4%), "endometrioid" in 12 (41.4%), "clear cell" in 2 (6.9%), "adenosquamous" in 2 (6.9%), and "serous" or "papillary" in 1. Foci of papillary and endometrioid metaplasia were present in 2 adenocarcinomas of endocervical type. The following histochemical methods were used: PAS reaction, PAS reaction with diastase predigestion, Bleu Alcian at pH 2.5 and pH 1, mucicarmine, Toluidine Bleu at 0.3%. The "endocervical" type adenocarcinoma showed mucicarmine positive and PAS positive, diastase resistant material in the whole cytoplasm. This material was not metachromatic and Bleu Alcian positive only in the well differentiated forms. In the "endometrial" adenocarcinoma only in the apex of the glandular cells was PAS positive diastase resistant, Alcian and mucicarmine positive. "Clear cell" and "adenosquamous" carcinomas showed only few cytoplasmatic PAS positive, diastase sensitive granules (= glycogen). No positivity was present in the "papillary" or "serous" carcinomas. Our results permit us to unify the histological and the histochemical patterns of the cervical adenocarcinomas and those of the similar forms of the endometrium and of the ovary, and stress the common müllerian origin of these neoplasms.

Endocervical adenocarcinoma. Immunohistochemical characterization.

The presence of cytokeratins, IgA, alphafetoprotein (AFP), beta-Human Chorionic Gonadotropin (HCG), Carcinoembryonic antigen (CEA) and Epithelial Membrane Antigen (EMA) were immunohistochemically researched with a PAP method in 19 cases of endocervical adenocarcinoma. AFP and HCG were always absent, while the low and median molecular weight cytokeratins were present in 18 case (95%). These findings confirm the hypothesis of the tumoral histogenesis from the reserve cell of the endocervical epithelium. In 11 case (60%) there was a strong positivity of IgA in the lymphocytes surrounding the tumor nests, in the neoplastic cells and in the endoglandular secretion: this may represent a sign of an immune response of the patients to the tumoral antigens. CEA was present in 8 cases and EMA in 12 cases, with a unique expression: CEA positive cases showed no evidence of EMA and case with EMA positive cells were negative for the presence of CEA. Only in one case CEA and EMA were contemporaneously present. The possible interpretation of these findings is discussed.