Villoglandular Adenocarcinoma of the Cervix Is Associated with Normal Expression of Mismatch Repair Proteins
NM Conlon, R Geraghty, L Kehoe, JJ O Leary, D Gibbons. Coombe Women's Hospital, Dublin 8, Ireland; St Vincent's University Hospital, Dublin 4, Ireland
Background: Villoglandular adenocarcinoma of the cervix, a rare variant of cervical adenocarcinoma, has come to prominence in recent years due to an emerging consensus that the long-held belief in the indolent nature of this disease requires reassessment. Due to its relative rarity, there have been few investigations into the molecular genetics underlying the condition. Several previous studies have reported the presence of microsatellite instability (MSI) in 6-25% of all cervical carcinomas, but the number of cases of cervical adenocarcinoma included in these studies was low. The expression of mismatch repair proteins in the villoglandular subtype of cervical adenocarcinoma has not previously been assessed.
Design: We assembled a case series of eleven patients with villoglandular adenocarcinoma of the cervix who attended our centre over a ten year period. The epidemiological data and histopathological findings from the eleven patients were reviewed. We also undertook immunohistochemical analysis of the expression of four mismatch repair proteins (MLH1, PMS2, MSH2 and MSH6).
Results: Histological review confirmed the diagnosis of villoglandular adenocarcinoma of cervix in all cases. The average age at diagnosis was 32 years, with an age range from 26 years to 38 years. Eight patients underwent hysterectomy. At the time of review, no disease recurrence had been recorded in any case. All eleven cases demonstrated normal expression of mismatch repair proteins.
Conclusions: Villoglandular adenocarcinoma is a subtype of cervical adenocarcinoma which tends to present at a younger age than conventional endocervical adenocarcinoma. The genetic pathways underpinning the development of the disease remain to be elucidated. This series of eleven cases represents the first attempt to assess the expression of mismatch repair proteins in villoglandular cervical adenocarcinoma. The results suggest that there is no association between villoglandular adenocarcinoma of cervix and microsatellite instability.
Category: Gynecologic & Obstetrics
Tuesday, March 23, 2010 9:30 AM
Poster Session III # 185, Tuesday Morning