Mucin leakage into the cervical stroma may increase lymph node metastasis in mucin-producing cervical adenocarcinomas.
The relationships between the histologic feature of mucin leakage into the cervical stroma, lymph node metastasis, and the levels of serum carcinoembryonic antigen (CEA), CA 19-9, and CA 125 were analyzed in 35 cases of cervical adenocarcinoma. Histologically, mucin leakage was identified in 14 (40%) cases as amorphorous materials dissecting the connective tissues and permeating the lymphatic channels, associated with or without cancer cells. The cases with mucin leakage showed a significantly higher incidence of lymph node involvement than those without mucin leakage (71.4% versus 23.8%; P less than 0.01). In addition, when the mucin leakage was immunohistochemically positive for CEA or CA 19-9, elevated serum levels of these antigens were frequently observed. These results suggest that the mucin leakage into the cervical stroma represents not only stromal invasion, but also a means that frequently conducts cancer cells into the lymphatic channels. Clinically, this is reflected in an elevation of serum CEA or CA 19-9 levels in cervical adenocarcinoma patients.
Konishi
I
I
Department of Gynecology and Obstetrics, Faculty of Medicine, Kyoto University, Japan.
Fujii
S
S
Nanbu
Y
Y
Nonogaki
H
H
Mori
T
T
D002288:Adenocarcinoma, Mucinous / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000556:secondary*; D000328:Adult; D000368:Aged; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000032:analysis; D002272:Carcinoembryonic Antigen / Q000032:analysis; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009077:Mucins / Q000378:metabolism*; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology
D015295:Antigens, Tumor-Associated, Carbohydrate; D002272:Carcinoembryonic Antigen; D009077:Mucins