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Endo cervical adeno cancer12/14/2023 Horizontal extent of invasion – This is the amount of invasion measured from one side of the tumour to the other..Depth of invasion – This is the amount of invasion measured from the surface of the tumour to the deepest point of invasion.Most pathology reports will describe the amount of stromal invasion in two directions: Endocervical adenocarcinoma starts in the epithelium but as the tumour grows, the cells spread into the stroma. The tissue that covers the inside surface of the cervix is called the epithelium while the tissue just below the epithelium is called the stroma. Tumour extension into other organs or the parametrium around the cervix is important because it is associated with a worse prognosis and is used to determine the tumour stage. Pathologists use the term tumour extension to describe how far the cancer cells have travelled from their starting point in the cervix into surrounding organs and tissues. Has the tumour spread outside of the cervix?Īll endocervical adenocarcinomas start in the cervix however larger tumours can grow to involve nearby organs such as the endometrium, vagina, bladder, or rectum or supporting tissues such as the parametrium. Depth of invasion – The tumour is measured from the epithelium on the surface of the cervix to the cancer cells at the very deepest point of invasion..Width – The tumour is measured from side to side.Length – The tumour is measured from top to bottom.These measurements are important because they are used to determine the pathologic tumour stage (see Pathologic stage below). The tumour is measured in three dimensions – length, width, and depth of invasion. How do pathologists determine the tumour size for endocervical adenocarcinoma and why is it important? The differentiation of the tumour is important because less differentiated tumours (for example, those that are poorly differentiated) tend to grow faster and are more likely to spread to other parts of the body. The three levels are called well differentiated, moderately differentiated, and poorly differentiated. Pathologists divide endocervical adenocarcinoma into three levels or grades based on how much of the tumour is making glands similar to those normally found in the cervix. What does it mean if endocervical adenocarcinoma is described as well differentiated, moderately differentiated, or poorly differentiated? As a result, this test is used to confirm the diagnosis of endocervical adenocarcinoma and rule out other conditions that can look like endocervical adenocarcinoma under the microscope. When immunohistochemistry is performed, most endocervical adenocarcinomas are positive for p16. Pathologists can see this protein inside cells by performing a test called immunohistochemistry. What is p16 and why is it important?Ĭells infected with high-risk types of HPV typically produce large amounts of a protein called p16. The tumour is made of round structures called glands that invade the cervical stroma. The diagnosis can also be made after a larger sample of tissue is removed in a biopsy or resection. After the initial diagnosis is made, most patients are offered surgery to remove the entire tumour. The diagnosis of endocervical adenocarcinoma is usually made after some cells are removed from the cervix during a Pap test. How is endocervical adenocarcinoma diagnosed? At present, doctors do not know what causes the other 15 to 20% of cases that are not associated with HPV. These tumours account for about 80 to 85% of cases worldwide. The most common cause of endocervical adenocarcinoma is infection with high-risk types of human papillomavirus (HPV), specifically types 16, 18, and 45. Less common symptoms include pelvic pain and pressure. The most common symptom of endocervical adenocarcinoma is abnormal uterine bleeding. What are the symptoms of endocervical adenocarcinoma? Most tumours develop from a non-invasive type of cancer called endocervical adenocarcinoma in situ (AIS). It develops from glandular cells normally found in a part of the cervix called the endocervical canal. Endocervical adenocarcinoma is a type of cervical cancer.
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