Neuroendocrine differentiation in cervical carcinoma.

Journal of Clinical Pathology - Tập 49 Số 2 - Trang 139-141 - 1996
Pratima Savargaonkar1, R Hale1, Adrienne Mutton1, V Manning1, C. H. Buckley1
1Department of Reproductive Pathology, St Mary's Hospital, Manchester.

Tóm tắt

AIMS: To examine neuroendocrine differentiation, as shown by chromogranin A (CGA) expression, in cervical carcinomas. METHODS: Sixty seven cervical carcinomas were studied and were classified as adenocarcinomas, adenosquamous carcinomas or squamous cell carcinomas based on the assessment of haematoxylin and eosin staining and stains for mucin. Where features of glandular differentiation were identified, sections were also stained for evidence of intestinal type mucin. CGA immunostaining was done and the results were graded on a three point scale: 0, + (1-5% of cells positive) and ++ (> 5% of cells positive). These findings were then analysed with respect to lymph node status, tumour differentiation and clinical outcome. RESULTS: There were 32 adenocarcinomas, 18 adenosquamous carcinomas and 17 squamous cell carcinomas. Positive staining was seen in 14 (20.9%) cases, of which four were strongly positive. All but one case were either adenocarcinomas or adenosquamous carcinomas. There was a trend for CGA positivity to be related to intestinal differentiation but this failed to reach statistical significance. No correlation could be demonstrated between CGA staining and lymph node status, tumour differentiation and clinical outcome. CONCLUSIONS: Neuroendocrine differentiation is common in cervical carcinomas where there is evidence of glandular differentiation. Whilst the numbers in this study are relatively small, the presence of neuroendocrine cells in otherwise typical carcinomas does not seem to have any association with clinical behaviour.

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Tài liệu tham khảo

Ueda G, Yamasaki M. Neuroendocrine carcinoma of the uterus. Curr Top Pathol 1992;85:309-35.

Buckley CH, Fox H. Carcinoma of the cervix. In: Anthony PP, MacSween RNM, eds. Recent advances in histopathology. Vol 14. London: Churchill Livingstone, 1989: 63-78.

Savargaonkar PR, Hale RJ, Pope R, Fox H, Buckley CH. Enteric differentiation in cervical adenocarcinomas and its prognostic significance. Histopathology 1993;23:275-7.

Fox H, Kazzaz B, Langley FA. Argyrophil and argentaffin cells in the female genital tract and in ovarian mucinous cysts. J Pathol Bact 1964;88:479-88.

FetissofF, Dubois MP, Heitz PU, LansacJ, Arbeille-Brassart B, Jobard P. Endocrine cells in the female genital tract. IntJ Gynecol Pathol 1986;5:75-87.

Tateishi R, Wada A, Hayakawa K, Hongo J, Ishii S. Argyophil cell carcinomas (apudomas) of the uterine cervix. Light and electron microscopic observations of 5 cases. Virchows Arch A PatholAnat Histopathol 1975;366:257-74.

Stahl R, Demopoulos RI, Bigelow B. Carcinoid tumor within a squamous cell carcinoma of the cervix. Gynecol Oncol 1981;11:387-92.

Mullins JD, Hilliard GD. Cervical carcinoid ('Argyrophil cell' carcinoma) associated with an endocervical adenocarcinoma. A light and ultrastructural study. Cancer 1981; 47:785-90.

Sidhu GS. The endodermal origin of digestive and respiratory tract APUD cells. Histopathologic evidence and a review of the literature. Am J Pathol 1979;96:5-20.

Cheng H, Leblond CP. Origin, differentiation and renewal of the four main epithelial cell types in the mouse small intestine. V. Unitarian theory of the origin of the four epithelial cell types. AmJAnat 1974;141:537-61.

Inoue M, Delellis RA, Scully RE. Immunohistochemical demonstration of chromogranin in endometrial carcinomas with argyrophil cells. Hum Pathol 1986;17:841-7.

Ueda G, Nishino T, Saito J, Abe Y, Shimizu H, Tanizawa 0. Detection of chromogranin in argyrophil cells of endometrial carcinoma. Gynecol Oncol 1987;27:159-65.

Inoue M, Ueda G, Nakajima T. Immunohistochemical demonstration of neuron-specific enolase in gynecologic malignant tumors. Cancer 1985;55: 1686-90.

Lloyd RV, Mervac T, Schmidt K, Warner TF, Wison BS. Immunohistochemical detection of chromogranin and neuron-specific enolase in pancreatic endocrine neoplasms. Am J Surg Pathol 1984;8:607-14.

Ueda G, Shimizu C, Shimizu H, Saito J, Tanaka Y, Inoue M, et al. An immunohistochemical study of small cell and poorly differentiated carcinomas of the cervix using neuroendocrine markers. Gynecol Oncol 1989;34: 164-9.

Barrett RJ, Davos I, Leuchter RS, Lagasse LD. Neuroendocrine features in poorly differentiated and undifferentiated carcinomas of the cervix. Cancer 1987;60: 2325-30.

Hamada Y, Oishi A, Shoji T, Takada H, Yamamura M, Hioki K, etal. Endocrine cells and prognosis in patients with colorectal carcinoma. Cancer 1992;69:2641-6.

Piehl MR, Gould VE, Warren WH, Lee I, Radosevich JA, Ma YX, et al. Immunohistochemical identification of exocrine and neuroendocrine subsets of large cell lung carcinomas. PatholRes Pract 1988;183:675-82.

O'Hanlan KA, Goldberg GL, Jones JG, Runowicz CD, Ehrlich L. Adjuvant therapy for neuroendocrine small cell carcinoma of the cervix: review of the literature. Gynecol Oncol 1991;43:167-72.