The biologic behavior of squamous cervical carcinoma after neoadjuvant therapy (NAT) according to immunohistochemical expression of E-cadherin and CD44v6

Abstract

The efficiency of neoadjuvant therapy in cervical carcinoma has been well demonstrated, although the cellular mechanisms of different response to this treatment have not been thoroughly investigated. The present study consists of 24 patients with cervical cancer, including 12 patients in stages IB-IIIB with first-line surgical treatment and 12 patients in stages IIB-IIIB, with neoadjuvant therapy followed by radical hysterectomy. The aim of our study was to assess the correlations between the alterations in E-cadherin and CD44v6 immunoexpression in cervical carcinoma, as a tool of evaluation the response to neoadjuvant therapy and its prognostic significance. The intensity of CD44v6 immunoexpression was higher in more aggressive tumors and E-cadherin immunoexpression was approximately constant among the cases with neoadjuvant therapy. Our results demonstrate that the evaluation of CD44v6 immunoexpression in cervical carcinomas is useful for the assessment of tumor response to neoadjuvant therapy and of tumor aggressiveness. The high level of E-cadherin immunoexpression in tumors with neoadjuvant therapy reflects its involvement in the prevention of HPV oncoproteins action, with benefits on the outcome. A larger group of patients and a panel of antibodies, including CD4 and COX2, could provide a better characterization of the tumor response to neoadjuvant therapy, with a positive prognosis impact.