2020年世界卫生组织（WHO）分类将子宫颈内腺癌（ADC）分为人乳头瘤病毒（HPV）相关（HPVA）和HPV非相关（HPVI）ADC。本多机构研究旨在基于更新的WHO分类调查患有子宫颈ADC的患者的临床特征和预后。我们回顾性研究了来自七个机构共365名接受根治性子宫切除术的子宫颈ADC患者。比较了HPVA和HPVI ADC之间的肿瘤特征、失败模式和生存结果。其中275名（75.3%）和90名（24.7%）患者分别被诊断为HPVA和HPVI ADC。在所有情况下，五年无病生存率（DFS）和总生存率（OS）分别为58.2%和71.3%。与HPVA ADC相比，HPVI ADC表现出更高的局部复发率（25.6% vs. 10.9%）和远处转移率（33.3% vs. 17.5%）。多变量生存分析显示，与HPVA ADC相比，HPVI ADC显示出显着更差的DFS（风险比[HR]，1.919；95%置信区间[CI]，1.324-2.781；P <0.001），远处转移无病生存（HR，2.100；95% CI，1.397-3.156；P <0.001）和OS（HR，2.481；95% CI，1.586-3.881；P <0.001）。胃和漏斗型HPVI ADC患者的OS明显较其他HPVI ADC患者更差（P = .020）。同样，侵袭性分层黏液产生（ISM）型HPVA ADC表现出较其他HPVA ADC更差的OS（P <0.001）。我们证明，与HPVA ADC相比，HPVI ADC表现出较差的DFS和OS以及更高的局部和远处复发率。胃和漏斗型HPVI ADC和ISM型HPVA ADC的患者的OS比其他HPVI和HPVA ADC的患者更差，需要在更大的子宫颈ADC患者队列中验证我们观察到的组织学类型的预后差异。 版权所有©2023 Elsevier Inc. 发布。

The 2020 World Health Organization (WHO) classification divided endocervical adenocarcinoma (ADC) into human papillomavirus (HPV)-associated (HPVA) and HPV-independent (HPVI) ADCs. This multi-institutional study aimed to investigate the clinical features and prognosis of patients with endocervical ADC based on the updated WHO classification.We retrospectively reviewed the 365 patients with endocervical ADC who underwent radical hysterectomy from seven institutions. Tumor characteristics, patterns of failure, and survival outcomes were compared between HPVA and HPVI ADCs.Two hundred and seventy-five (75.3%) and 90 (24.7%) patients were diagnosed with HPVA and HPVI ADCs, respectively. In all cases, the five-year disease-free survival (DFS) and overall survival (OS) rates were 58.2% and 71.3%, respectively. HPVI ADC showed higher rates of local recurrence (25.6% vs. 10.9%) and distant metastasis (33.3% vs. 17.5%) than HPVA ADC. Multivariate survival analysis revealed that HPVI ADC showed significantly worse DFS (hazard ratio [HR], 1.919; 95% confidence interval [CI], 1.324-2.781; P < .001), distant metastasis-free survival (HR, 2.100; 95% CI, 1.397-3.156; P < .001), and OS (HR, 2.481; 95% CI, 1.586-3.881; P < .001) than HPVA ADC. Gastric- and serous-type HPVI ADC patients had significantly worse OS than those with other HPVI ADCs (P = .020). Similarly, invasive stratified mucin-producing (ISM)-type HPVA ADC showed significantly worse OS than other HPVA ADCs (P < .001).We demonstrated that HPVI ADC exhibited inferior DFS and OS and higher rates of local and distant recurrence compared to HPVA ADC. Gastric- and serous-type HPVI ADCs and ISM-type HPVA ADC showed worse OS than other types of HPVI and HPVA ADCs, respectively. Our observation of significant differences in prognoses according to the histological types needs to be validated in larger cohorts of endocervical ADC patients.Copyright © 2023. Published by Elsevier Inc.