[992] Rare Cervical Cancers: Immunohistochemistry and Correlation with HPV Infection Status by In-Situ Hybridization and Linear Array.

Ghassan Allo, Ming Tsao, Marjan Rouzbahman, Cuihong Wei, Suzanne Kamel-Reid, Golnar Rasty. University Health Network, Toronto, ON, Canada

Background: Human papilloma virus (HPV) is a major etiologic factor in the development of cervical epithelial malignancies. Limited data is available on the less common cervical tumors. Our aim is to examine HPV status, and its correlation with immunohistochemical expression in rare cervical carcinomas and mixed tumors.
Design: Pathology archives at the department of Anatomic Pathology, were searched for primary cervical carcinomas excluding squamous cell carcinoma, adenocarcinoma and adenosquamous carcinoma from 2000 till now. 34 cases were retrieved which include adenoid basal (AB) carcinoma (n=2), clear cell (CC) carcinoma (n=2), glassy cell (GL) carcinoma (n=2), lymphoepithelioma – like (LE) carcinoma (n=3), serous (SR) carcinoma (n=9), villoglandular (VG) carcinoma (n=4), and neuroendocrine (NE) carcinoma (small cell, large cell, mixed carcinomas). The histopathology was reviewed by 2 pathologists. Chromogenic in-situ hybridization (CISH) –INFORM HPV (13 genotypes) and Roche Linear array HPV genotyping (37 genotypes) were performed on all cases. The following immunoperoxidase stains were performed on tissue microarray: (LMWK),CK 5/6,p16, p63, p53, Synaptophysin, Chromogranin, CD56, ER, PR, TTF-1, WT-1 and Ki67.
Results: High risk HPV-DNA is identified in 30% of serous carcinoma and 75% of NE carcinoma. Expression of NE markers in mixed NE carcinoma suggest pluripotential nature of the tumor. p16 is expressed in almost all tumors. p53 is mainly expressed in CC and GL with no expression in serous carcinoma of cervix. WT-1 is negative in all cervical carcinomas.

Expression of IHC markers and HPV

Cases	p16	p63	p53	NE marker	HPV status	HPV+/case #
AB	1+, 30-60%	3+, 100%	<10%	0	-/+	1/2
CC	3+, 100%	0	2+, 30-60%	0	-	0/2
GL	2+, 50%	2+, 100%	2+, 30-60%	0	+	1/2
LE	2+, 100%	3+, 100%	0	0	+	2/3
SR	2+, 100%	0	0	10%	+	3/9
VG	3+, 100%	0	<5%	25%	+	4/4
NE	2+, 100%	3+, 10%	<5%	75%	+	9/12

1-3: intensity, % of tumor cells involved


Conclusions: Our study demonstrates that the majority of rare carcinomas of cervix, including NE variants are positive for high-risk HPV which may suggest a unique carcinogenic pathway induced by the virus. This finding may have a role in tailoring HPV sub-type selection for vaccine and also theraputic strategies.
Our data also suggest that tumors with serous type morphology and p53 expression are possibly derived from uterine corpus and should be treated accordingly.
Category: Gynecologic & Obstetrics

Monday, February 28, 2011 9:30 AM

Poster Session I Stowell-Orbison/Surgical Pathology/Autopsy Awards Poster Session # 130, Monday Morning