Detection of HPV-DNA by PCR-Based Method in Formalin Fixed, Paraffin Embedded Tissue of Rare Types of Endocervical Carcinoma
S Nofech-Mozes, MA Khalifa, N Ismiil, RS Saad, V Dube, P Sun, A Seth, Z Ghorab. Sunnybrook Health Sciences Centre, Toronto, Canada
Background: In addition to its role as a key risk factor for cervical squamous neoplasia, high risk HPV also appears to play a role in the pathogenesis of conventional endocervical adenocarcinomas of the mucinous and endometrioid cell types. Cervical serous, clear cell and small cell carcinomas differ from the conventional endocervical adenocarcinoma in their clinical characteristics. The data on the role of HPV in their pathogenesis are limited. In this study we examined the presence of high risk HPV-DNA in rare types of cervical carcinoma using polymerase chain reaction (PCR)-based test.
Design: In-house cervical serous, clear cell and small cell carcinoma cases accessioned between 2000-2008 were retrieved. The diagnosis of cervical serous or clear cell carcinoma was made only in the absence of concurrent or previous primary endometrial, ovarian or peritoneal carcinoma. Small cell neuroendocrine carcinoma was diagnosed when it expressed at least one neuroendocrine marker; chromogranin A or synaptophysin. Cases were tested for HPV by PCR amplification of DNA extracted from deparaffinized sections using Roche AMPLICOR HPV Amplification Detection and Control Kits (Roche Molecular Systems, CA, USA). The kit detects all 13 high-risk DNA genotypes HPV. The positive cut-off point for AMPLICOR HPV Test was A450 = 0.2.
Results: We identified 4 serous carcinomas, 3 clear cell carcinomas, 1 mixed clear cell and serous and 5 small cell carcinomas that met our inclusion criteria. High risk HPV DNA tested positive in 3/4 serous carcinomas, 2/3 cervical clear cell carcinomas, all 5 cases of small cell carcinoma and the mixed cell type.
Conclusions: Our report is the first to document HPV status in a series of archival unusual types of adenocarcinoma of the uterine cervix. It suggests a robust association between high risk HPV and these rare subtypes. Despite their unique clinical setting and morphologic appearance, the majority of these tumors likely share a common HPV-mediated carcinogenic pathway. Our observation is particularly significant in cervical cancer prevention as we enter the HPV vaccination era.
Monday, March 9, 2009 1:00 PM
Poster Session II # 147, Monday Afternoon