Open Access Research

Clonal status and clinicopathological observation of cervical minimal deviation adenocarcinoma

Li Gong1, Wen-Dong Zhang2, Xiao-Yan Liu1, Xiu-Juan Han1, Li Yao1, Shao-Jun Zhu1, Miao Lan1, Yan-Hong Li1* and Wei Zhang1*

Author affiliations

1 Department of Pathology, Tangdu Hospital, the Fourth Military Medical University, Shaanxi Xi'an 710038, China

2 Department of Nuclear Medicine, Tangdu Hospital, the Fourth Military Medical University, Shaanxi Xi'an 710038, China

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Citation and License

Diagnostic Pathology 2010, 5:25  doi:10.1186/1746-1596-5-25

Published: 24 April 2010



Minimal deviation adenocarcinoma (MDA) of the uterine cervix is defined as an extremely well differentiated variant of cervical adenocarcinoma, with well-formed glands that resemble benign glands but show distinct nuclear anaplasia or evidence of stromal invasion. Thus, MDA is difficult to differentiate from other cervical hyperplastic lesions. Monoclonality is a major characteristic of most tumors, whereas normal tissue and reactive hyperplasia are polyclonal.


The clinicopathological features and clonality of MDA were investigated using laser microdissection and a clonality assay based on the polymorphism of androgen receptor (AR) and X-chromosomal inactivation mosaicism in female somatic tissues.


The results demonstrated that the glands were positive for CEA, Ki-67, and p53 and negative for estrogen receptor (ER), progesterone receptor (PR), and high-risk human papilloma virus (HPV) DNA. The index of proliferation for Ki-67 was more than 50%. However, the stromal cells were positive for ER, PR, vimentin, and SM-actin. The clonal assay showed that MDA was monoclonal. Thus, our findings indicate that MDA is a true neoplasm but is not associated with high-risk HPV.


Diagnosis of MDA depends mainly on its clinical manifestations, the pathological feature that MDA glands are located deeper than the lower level of normal endocervical glands, and immunostaining.