Abstract

BackgroundThe origin of adenocarcinomas presenting on the cervix uteri may be doubtful, i.e. whether it is of cervical or endometrial origin, due to the overlapping morphological features. In HPV negative samples, further tests may be needed to ascertain the nature of the tumours. We aimed to explore the use of immunohistochemistry profiles in tissue microarrays in archived samples of adenocarcinoma (ADC) of the cervix from Uganda that tested negative for HPV DNA.FindingsFive commercially available antibodies were tested in tissue array sections immunostained utilizing the avidin-biotin (AB) technique. In 26 ADC samples, HPV was detected in 13, p16 in 15 (8 in HPV positive and 7 in HPV negative), CEA in 12, vimentin in 6, ER in 0, and PR in 2. Among the 13/25 HPV negative ADC samples, five were positive for CEA suggesting endocervical origin, and three were vimentin positive (one had a mucinous endocervical histological pattern and two were ADC, not otherwise specified, most likely of endometrial origin).ConclusionsThe immunoprofiles of ADC with the antibodies studied are rather nonspecific. By using immunohistochemistry in 13 HPV negative ADC, endocervical tumour origin was suspected in five CEA positive cases while two out of three vimentin positive samples were probably of endometrial origin, suggesting that CEA and vimentin may be valuable in distinguishing HPV negative cervical adenocarcinomas from endometrial adenocarcinomas.

Highlights

  • The origin of adenocarcinomas presenting on the cervix uteri may be doubtful, i.e. whether it is of cervical or endometrial origin, due to the overlapping morphological features

  • By using immunohistochemistry in 13 HPV negative ADC, endocervical tumour origin was suspected in five carcinoembryonic antigen (CEA) positive cases while two out of three vimentin positive samples were probably of endometrial origin, suggesting that CEA and vimentin may be valuable in distinguishing HPV negative cervical adenocarcinomas from endometrial adenocarcinomas

  • We aimed to explore the utility of immunohistochemistry profiles, i.e. the expression of p16, carcinoembryonic antigen (CEA), vimentin, estrogen receptor alpha (ER) and progesterone receptor (PR), in tissue microarrays in archived samples of ADC that had been tested for HPV DNA, and in particular to assess if it would be possible to define the tissue of origin of HPV negative adenocarcinoma samples

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Summary

Introduction

The origin of adenocarcinomas presenting on the cervix uteri may be doubtful, i.e. whether it is of cervical or endometrial origin, due to the overlapping morphological features. We aimed to explore the utility of immunohistochemistry profiles, i.e. the expression of p16, carcinoembryonic antigen (CEA), vimentin, estrogen receptor alpha (ER) and progesterone receptor (PR), in tissue microarrays in archived samples of ADC that had been tested for HPV DNA, and in particular to assess if it would be possible to define the tissue of origin of HPV negative adenocarcinoma samples. This was based on the use of CEA as a marker of endocervical ADC, vimentin and hormone receptors (markers more related to endometrial ADC) and p16 as a proxy marker for HPV infection. They are used usually to exclude endocervical origin of tumours

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