Primary Squamous Cell Carcinomas of Upper Genital Tract Show Immunonegativities for P16INK4a and Absence of Human Papilloma Virus DNA
Su Hyun Yoo, Eun-Mi Son, Chang Okh Sung, Kyu-Rae Kim. University of Ulsan College of Medicine, Seoul, Korea
Background: Squamous cell carcinoma (SCC) involving upper genital tract, including endometrium, fallopian tube and ovary, is exceedingly rare. Possible pathogenetic mechanisms are; 1) de novo carcinogenesis, 2) extensive squamous metaplasia with malignant transformation into squamous cell carcinoma, 3) endometrioid adenocarcinoma with predominant squamous differentiation, and 4) mucosal spread from cervical squamous cell carcinoma. Thus, before making a diagnosis of primary SCC arising in the upper genital tract, mucosally spred cervical SCC should be excluded by thorough examination of the uterine cervix. In the diagnosis on the endometrial biopsy or curettage samples, the decision of primary or metastatic SCC can be very difficult.
Design: To examine the pathogenetic role of HPV and its utility in the differential diagnosis, we compared the immunoexpression for P16INK4a between the primary SCC of the upper genital tract and mucosally spred cervical SCC, and examined human papilloma virus (HPV) DNA using DNA chip. Nine cases of SCC involving upper genital tract including endometrium, fallopian tube or ovary were divided into the mucosal extension of cervical SCC (n=5), and the primary SCC arising in the upper genital tract (n=4) depending on the presence or absence of cervical SCC after thorough histological examination. Metastatic carcinoma, endometrioid adenocarcinoma and SCC arising in ovarian teratoma were carefully excluded.
Results: All SCC of cervical origin (n=5) showed strong expression of P16INK4a, and three of them showed high risk HPV DNA, while primary SCC of primary endometrium and ovary were all negative for p16INK4a and HPV DNA.
Conclusions: Primary SCC of upper genital tract appear to have a different pathogenetic mechanism from that of cervical SCC, and immunonegativity for P16INK4a is a useful adjunct in the decision of primary or metastatic SCC of upper genital tract.
Category: Gynecologic & Obstetrics
Wednesday, March 6, 2013 1:00 PM
Poster Session VI # 204, Wednesday Afternoon