Distinguishing between primary endocervical and endometrial adenocarcinomas: is a 2-marker (Vim/CEA) panel enough?

• Published in: Virchows Archiv : an international journal of pathology Vol. 456; no. 4; pp. 377 - 386
• Main Authors: Liao, Chiung-Ling, Hsu, Jeng-Dong, Lee, Ming-Yung, Kok, Lai-Fong, Li, Yi-Ju, Wang, Po-Hui, Yao, Chung-Chin, Han, Chih-Ping
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.04.2010; Springer; Springer Nature B.V
• Subjects: Adenocarcinoma - diagnosis; Adenocarcinoma - metabolism; Biological and medical sciences; Biomarkers, Tumor - metabolism; Biotin; Carcinoembryonic Antigen - metabolism; Cyclin-Dependent Kinase Inhibitor p16 - metabolism; Diagnosis, Differential; Endometrial Neoplasms - diagnosis; Endometrial Neoplasms - metabolism; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Humans; Immunohistochemistry - methods; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Medicine; Medicine & Public Health; Original Article; Pathology; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Protein Array Analysis - methods; Receptors, Estrogen - metabolism; Receptors, Progesterone - metabolism; Tumors; Uterine Cervical Neoplasms - diagnosis; Uterine Cervical Neoplasms - metabolism; Vimentin - metabolism; Vimentin; Carcinoembryonic antigen; Endometrial; p16; Immunohistochemistry (IHC); Estrogen; Tissue microarray; Endocervical; Progesterone; Adenocarcinomas; Immunohistochemistry; Endometrium cancer; Biological marker; Tumoral marker; Uterine cervix; CDKN2 gene; Uterus; Tissue microarrays; Female genital system; Primary; Uterine diseases; Endometrium; Tumor suppressor gene; Endometrium adenocarcinoma; Tumor associated antigen; Oncofetal antigen; Malignant tumor; Ovarian hormone; Female genital diseases; Anatomic pathology; Sex steroid hormone; Cancer
• ISSN: 0945-6317; 1432-2307
• DOI: 10.1007/s00428-010-0892-x

Gynecological pathologists are used to operating many panels of various markers in combination for the diagnostic distinction between primary endocervical and endometrial adenocarcinomas. The conventional 3-marker (ER/Vim/CEA) panel is the most promising tool. In this study, our aim is to investigate whether a 2-marker panel is enough to distinguish between these two gynecologic malignancies. Additionally, we wish to determine which one is the most favorable among eight panels tested, including six 2-marker (ER/CEA, PR/CEA, Vim/CEA, ER/p16 INK4a , PR/p16 INK4a , Vim/p16 INK4a ) and two 3-marker (ER/Vim/CEA, ER/Vim/p16 INK ) panels. A tissue microarray was constructed using paraffin-embedded, formalin-fixed tissues from 35 hysterectomy specimens, including 14 primary endocervical adenocarcinomas and 21 primary endometrial adenocarcinomas. Utilizing the avidin-biotin complex (ABC) method, tissue array sections were immunostained with five commercially available antibodies (ER, Vim, CEA, PR, and p16 INK4a ) to evaluate their individual frequencies of expression. We found that all eight aforementioned panels showed an encouraging range of overall accuracy (69.2% to 78.3%). However, one panel of 2-markers (Vim, CEA) exhibited the most efficiency (78.3%) in the diagnostic distinction between primary endocervical and endometrial adenocarcinomas. Based on the analyzed data, we conclude that the 2-marker (Vim/CEA) panel seems adequate to be an appropriate, convenient, and efficient means to distinguish between primary endocervical and endometrial adenocarcinomas. Even though there were a limited number of cases, this study still provides valuable references to help avoid wasting resources and unnecessary marker testing.