The Desmoplastic Stromal Response as Defined by Positive α-Smooth Muscle Actin Staining Is Predictive of Invasion in Adenocarcinoma of the Uterine Cervix
Sara M Jordan, Tawny Watanabe, Kathryn Osann, Bradley J Monk, Fritz Lin, Joanne K Rutgers. University of California, Irvine, Orange, CA; University of California, Irvine, Irvine, CA; Creighton University School of Medicine, Phoenix, AZ; Long Beach Memorial Medical Center, Long Beach, CA
Background: The overall incidence of cervical carcinoma has decreased over the past four decades, however the incidence of glandular lesions of the cervix, both adenocarcinoma in situ (AIS) and adenocarcinoma (AC), have increased. The differentiation between AIS and AC is clinically important because accurate diagnosis leads to appropriate triage and counseling of high risk patients. Unfortunately, histological features described to differentiate between AIS and AC are frequently insufficient. Surrogate histopathologic markers for invasion are needed.
Design: The objectives of this research were to examine the IHC profiles of AIS and early AC to identify biomarkers that enhance accurate diagnosis. The H&E and IHC of 20 women with glandular lesions were independently reviewed by two pathologists fellowship-trained in gynecologic pathology. Biomarkers included: α-SMA, ER, CEA, Ki67, p16, COX-2, and CD1a. Each stain was described according to pattern, intensity of staining, and percentage of positive cells. Statistical analysis was performed using SYSTAT v. 11.0.
Results: A statistically significant increased staining of the periglandular stroma for α-SMA was seen in AC as compared to AIS. Intensity was 1.2 versus 2.2 (p=0.04) and percent of positive staining cells was 18% versus 44% (p=0.05) in AIS and AC, respectively. Figures 1 illustrate the staining patterns of AIS (left) and AC (right). No significant difference was seen in the other biomarkers studied.
Conclusions: The presence of a desmoplastic stromal response as identified by increased periglandular staining for α-SMA is useful in identifying invasive glandular lesions of the endocervix. Further studies are necessary to confirm these findings and to establish biologically relevant cut-off values for α-SMA staining.
Category: Gynecologic & Obstetrics
Tuesday, March 20, 2012 1:00 PM
Poster Session IV # 124, Tuesday Afternoon