A study on the possibility of preoperative diagnosis of gastric-type adenocarcinoma in multiple cystic lesions of the cervix

Abstract

Synopsis: Preoperative diagnosis of gastric-type adenocarcinoma in multiple cystic lesions of the cervix is difficult. This study investigated the optimal screening of gastric-type adenocarcinoma in 123 patients who underwent cervical mucin test using the HIK1083 mAb. Nineteen patients exhibited gastric-type mucin-producing lesions, with a positivity rate of 63.1%for the HIK1083 test. Among these, seven had malignant tumors (including four cases of minimal deviation adenocarcinoma; two of HPV-independent gastric type adenocarcinoma; and one of gastric type adenocarcinoma in situ) and 12 had benign lesions diagnosed as lobular endocervical glandular hyperplasia. Univariate analysis revealed yellowish mucin on cytology and decreased diffusion on MRI imaging as significant factors distinguishing benign from malignant gastric-type mucin-producing lesions. In a multivariate analysis of 38 patients with final pathologic diagnosis and preoperative MRI imaging, a positive HIK1083 test, yellowish mucin, and decreased diffusion emerged as significant factors for screening gastric-type adenocarcinoma. Consequently, in cases of multiple cystic lesions of the cervix, the combination of clinical data—such as positive HIK1083 test, yellowish mucin, and decreased diffusion—indicates the likely presence of gastric-type adenocarcinoma.