Molecular Correlates of Invasion Pattern in HPV-Associated Endocervical Adenocarcinoma: Emergence of Two Distinct Risk-Stratified Tiers.

Our findings further indicate that key molecular events in HPVA correlate with the morphologic invasive properties of the tumor and their aggressiveness. Pattern B tumors with LVI clustered with pattern C tumors, whereas pattern B tumors without LVI approached pattern A genotypically. Our study provides a biologic foundation for consolidating the Silva system into low-risk (pattern A + B without LVI) and high-risk (pattern B with LVI and pattern C) categories.