Ancillary p16(INK4a) adds no meaningful value to the performance of ER/PR/Vim/CEA panel in distinguishing between primary endocervical and endometrial adenocarcinomas in a tissue microarray study.
OBJECTIVE
Endocervical adenocarcinomas (ECA) and endometrial adenocarcinomas (EMA) are uterine malignancies that have differing biological behavior. The choice of appropriate therapeutic plan depends indeed on the tumor's site of origin. In this study, we not only compare the individual expression status of five immunomarkers (ER, PR, Vim, CEA, and p16(INK4a)), but also evaluate whether p16(INK4a) adds value to the ER/PR/Vim/CEA panel characteristics in distinguishing between primary ECA and EMA.


METHODS
A tissue microarray (TMA) was constructed using paraffin-embedded, formalin-fixed tissues from 35 hysterectomy specimens, including 14 ECA and 21 EMA. TMA sections were immunostained with five anti-bodies, by avidin-biotin complex (ABC) method for antigen visualization. The staining intensity and area extent of the immunohistochemical (IHC) reactions were appraised by using the semi-quantitative scoring system.


RESULTS
The four respective markers (ER, PR, Vim, CEA) and their combined panel expressions showed significant (p < 0.05) frequency differences between ECA and EMA tumors. The p16(INK4a) marker also revealed a significant frequency difference (p < 0.05) between the two sites of origin, but did not demonstrate to have any supplementary value to the 4-marker panel.


CONCLUSIONS
According to our data, when there is histomorphological and clinical doubt as to the primary site of origin, we recommend that the conventional 4-marker (ER/PR/Vim/CEA) panel is appropriate. Ancillary p16(INK4a)-marker testing does not add value to the 4-marker panel in distinguishing between primary ECA and EMA.
Yao
Chung-Chin
CC
Department of Surgery, Chung-Shan Medical University Hospital, Taichung, Taiwan. chungchin57@gmail.com
Kok
Lai-Fong
LF
Lee
Ming-Yung
MY
Wang
Po-Hui
PH
Wu
Tina S
TS
Tyan
Yeu-Sheng
YS
Cheng
Ya-Wen
YW
Kung
Mei-Fen
MF
Han
Chih-Ping
CP
D000230:Adenocarcinoma / Q000175:diagnosis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D002272:Carcinoembryonic Antigen / Q000032:analysis*; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000032:analysis*; D016889:Endometrial Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D040081:Protein Array Analysis; D011960:Receptors, Estrogen / Q000032:analysis*; D011980:Receptors, Progesterone / Q000032:analysis*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014746:Vimentin / Q000032:analysis*
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D019941:Cyclin-Dependent Kinase Inhibitor p16; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D014746:Vimentin