Resumé
Carcinoma of the uterine cervix is the most common gynaecological malignancy in the developing world despite being largely preventable. The non-squamous cancers of the cervix have not been properly documented in our setting. This study is aimed at reviewing the histological types of non-squamous cell cancers of the uterine cervix in relation to the age of presentation, and to analyze some of the histopathological features of adenocarcinomas. Cases of cancer of the cervix histologically diagnosed between January 1989 and December 2004 were extracted from the cancer register of the University of Maiduguri Teaching Hospital. The request forms, slides, and some tissue blocks were retrieved from the archives of the Histopathology Department. The cases were histologically reviewed and the data analyzed using simple statistical methods. A total of 491 cases of cervical cancers were diagnosed. Of these, 432(88.0%) cases were squamous cell carcinomas while 59(12.0%) were non-squamous cell malignancies. Out of the 59 non-squamous cervical cancers, 42(71.2%) were endocervical-type adenocarcinomas, while serous papillary, clear cell, and adenosquamous carcinomas comprised 2(3.4%) cases each. Seven (11.9%) cases were metastatic choriocarcinomas. Over 60% of these cases occurred within the third and fourth decades of life. Adenocarcinomas are the most common non-squamous malignancies of the cervix and their age of presentation was similar to that of their squamous cell counterpart. Haemorrhage and lymphocytic infiltrates were significantly associated with tumour grade while necrosis was independent of tumour grade.
Keywords: Carcinoma of the cervix; Adenocarcinoma; Histopathology
Résumé
Le carcinome du cervix utérin est un cancer gynécologique commun dans les pays sous développes bien que prevenable. Les cancers des cellules non squameuses du cervix n’ont pas été proprement documentés dans cette zone. Cette étude avaient pour but de revoir les registres des types histologiques des cancers des cellules non squameuse du cervical en fonction de l’age de présentations et l’analyse de certaines gouttes épaisses histologiques des adrenocarcinome au centre universitaire hospitalier de Maiduguri,entre Janvier 1989 á Décembre 2004. Au total 491 cas de cancer cervical étaient diagnostiques. 422 (88%) cas étaient des cellules squameuse carcinome, tandis que 59(12%) étaient des cellules non squameuse cancéreuse. Sur les 59 cas non squameux, 42(71.2%) étaient des adrenocarcinome endocervical de type alors que les papillaires séreuse, claire et carcinome adenosquanmeuse étaient de 2(3.4%). Sept (11.9%) des cas étaient des métastatiques choriocarcinome. Plus de 60% des cas apparairent entre le 3ieme et 4ieme dizaine de vie. Adrenocarcinmoes sont les cancers les plus commun non squameux du cervix et leur age de présentation était semblable á ceux des cellules squameuse. Hémorragie et les infiltrations lymphocytaires étaient significativement associes avec diverse degré de tumeurs alors que la nécrose était indépendant des grades de tumeur.
Correpondence: Dr. Ahmed A. Mayun, Histopathology Department, University of Maiduguri Teaching Hospital, PMB 1414, Maiduguri, Nigeria. E-mail: ahmadumayun@yahoo.com
Referencer
Uzoigwe SA and Seleye-Fubara D. Cancer of the uterine cervix in Port Harcourt, Rivers State-a 13-year clinicopathologic review. Nig J Med. 2004; 13 (2): 110-113.
Kitchener HC. Recent developments in cervical cancer. Africa Health. 1999; 21 (7): 24- 26.
Sherris J. Preventing cervical cancer in low resource settings. Outlook. 1998; 16(1): 1-8.
Kumar V, Abbas AK and Fausto N. Robbins and Cotran Pathologic basis of disease, 7th edition. India, Elsevier. 2004; p1072-1113.
Nkyekyer K. Pattern of gynaecological cancers in Ghana. East Afr Med J. 2000; 77 (10): 534-538.
Galadanchi HS, Jido TA, Muhammed AZ, Uzoho CC and Ochicha O. Gynaecological malignancies seen in a tertiary health facility in Kano, Nigeria. Trop J Obtet Gynaecol. 2003; 20 (2): 105-108.
Gichangi P, Estambule B, Bwayo J, Rogo K, Ojwang S, Opiyo A and Temmerman M. Knowledge and practice about cervical cancer and Pap smear testing among patients at Kenyatta National Hospital, Nairobi, Kenya. Int. J Gynaeco/Cancer. 2003;13 (6): 827-833.
Petry KU, Scholz U, Hollwitz B. Von Wasielewski R and Meijer CJ. Human papilloma
virus co-infection with Schistosoma haematobium and cervical cancer in rural Tanzania. Int. J Gynaecol Cancer. 2003; 13(4): 505-509.
Ajayi IO and Adewole IF. Breast and cervical cancer screening activities among family physicians in Nigeria. Afr J Med Med Sci. 2002;18(4): 305-309.
Amrani M, Lalaoni K, El Mzibri M, Lazo P and Belabbas MA. Molecular detection of Human papilloma virus in 594 uterine cervix samples from Moroccan women. J Clin Virol.2003; 27(3): 286-295.
Pindiga UH, El-Nafaty AU and Kyari O.Carcinoma of the uterine cervix as seen in a sub-Saharan tertiary health institution. Sahel Med J. 2001; 4 (3):
Pindiga UH, El-Nafaty AU and Ekanem IA. Female genital malignancies in Maiduguri, Nigeria: A review of 328 cases. Trop J Obstet and Gynaecol. 1999; 16(1):52-56.
Mayun AA, Pindiga UH and Bukar M. Histopathological review of 108 cases of carcinoma of the cervix in Gombe, North- eastern Nigeria. Borno Med J. 2006; 3(1): 25-27
Abdul MA, Muhammed A, Mayun AA and Shittu SO. Non-squamous cell cancers of the cervix In Zaria, Northern Nigeria: A clinicopathological analysis. Ann of Afr Med.2006; 5(3): 118 - 121
Silcocks PB, Thornton-Jones H and Murphy M. Squamous and adenocarcinoma of the uterine cervix: a comparison using routine data. Br J Cancer. 1987;55(3): 321-325.
Adelusi B, Smith JA and Junaid TA. Histopathological studies of carcinoma of cervix uteri in Ibadan. Afr J Med Med Sci. 1978; 7 (1): 9-16.
Adeniji KA. Analysis of the histopathological pattern of carcinoma of the cervix in Ilorin, Nigeria. Niger J Med. 2001;10(4): 165-168.
Ferenczy A and Winkler B. Carcinoma and metastatic tumours of the cervix. In: Kurman RJ. Blaustein’s Pathology of the Female Genital Tract, 3rd edition. New York, Springer Verlag: 1987; p236 – 244
Rosai J. Ackerman’s Surgical Pathology, 7th edition. Toronto, Mosby company: 1989; p1034 –1044
Miller DE, Flax SD, Arheart K, et al. The presentation of adenocarcinoma of the uterine cervix. Cancer. 1993; 72: 1281 – 1285
Vesterinen E, Forss M and Nieminen U. Increase of cervical adenocarcinoma: a report of 520 cases of cervical carcinoma including 112 tumours with glandular elements. Gynecol Oncol. 1989; 33: 49 – 53
Nieminen P, Kallio M, and Hakama M. The effect of mass screening on incidence and mortality of squamous and adenocarcinoma of cervix uteri. Obstet Gynecol. 1995; 85: 1017 - 1021