Study on the correlation between the etiological and Silva classification of cervical adenocarcinoma and clinical prognosis
10.13315/j.cnki.cjcep.2025.03.012
- VernacularTitle:子宫颈腺癌基于病因学分类、Silva分型与临床预后相关性研究
- Author:
Lin XIA
1
;
Qiaoyun GE
;
Guoqiang PING
;
Cong WANG
;
Yi XU
Author Information
1. 江苏省扬中市人民医院病理科,扬中 212200
- Publication Type:Journal Article
- Keywords:
cervical neoplasms;
adenocarcinoma;
HPV;
WHO classification;
Silva system;
prognosis
- From:
Chinese Journal of Clinical and Experimental Pathology
2025;41(3):352-358
- CountryChina
- Language:Chinese
-
Abstract:
Purpose Based on the WHO(5th edition)classification of cervical adenocarcinoma and Silva infiltra-tion pattern classification,this study explores the value of etiological classification and Silva classification in the clinical treatment and prognosis prediction of cervical adenocarcinoma.Methods The clinical and pathological features of 112 cases of cervical invasive adenocarcinoma were reviewed.Through HE morphological classification,immunohistochemi-cal detection,and Silva classification of infiltration pattern,the related factors and prognosis of patients were statistical-ly analyzed.Results The median age of 112 patients was 46.5 years(30-80 years),with a maximum tumor diame-ter of 0.35-9.0 cm and an average diameter of 3.2 cm.Most patients showed vaginal bleeding after sexual inter-course.89 cases were HPV-associated adenocarcinoma(HPVAs),18 cases were non HPV-associated adenocarcinoma(NHPVAs).There were 5 cases of other types of adenocarcinomas of the uterine cervix,including 4 cases of endome-trial adenocarcinoma and 1 case of serous adenocarcinoma.There were 5 cases(4.5％)of Silva A pattern,30 cases(26.8％)of Silva B pattern,and 77 cases(68.7％)of Silva C pattern.112 cases were followed up for a median time of 34 months(15-78 months),with 16 deaths and 20 metastases.The progression-free survival(PFS)(P＜0.001)and overall survival(OS)(P=0.001)in the NHPVA group were significantly lower than those in the HPVA group.All cases with Silva A and Silva B pattern had a favorable prognosis and survived without tumor.Of the cases with Silva C pattern,16 died after recurrence.The PFS and OS of patients with Silva C type were lower than those of Silva A type and B type(P＜0.05).Conclusion The fifth edition of WHO classification of cervical adenocarcinoma revealed the correlation between etiology and morphology.Silva classification is of great significance for accurately predicting progno-sis and guiding treatment.
