title: Progesterone receptor does not improve the performance and test effectiveness of the conventional 3-marker panel, consisting of estrogen receptor, vimentin and carcinoembryonic antigen in distinguishing between primary endocervical and endometrial adenocarcinomas in a tissue microarray extension study.
abstract: OBJECTIVE
  Endocervical adenocarcinomas (ECA) and endometrial adenocarcinomas (EMA) are uterine malignancies that have differing biological behaviors. The choice of an appropriate therapeutic plan rests on the tumor's site of origin. In this study, we propose to evaluate whether PR adds value to the performance and test effectiveness of the conventional 3-marker (ER/Vim/CEA) panel in distinguishing between primary ECA and EMA.
  
  
  METHODS
  A tissue microarray was constructed using paraffin-embedded, formalin-fixed tissues from 38 hysterectomy specimens, including 14 ECA and 24 EMA. Tissue microarray (TMA) sections were immunostained with 4 antibodies, using the avidin-biotin complex (ABC) method for antigen visualization. The staining intensity and extent of the immunohistochemical (IHC) reactions were appraised using a semi-quantitative scoring system.
  
  
  RESULTS
  The three markers (ER, Vim and CEA) and their respective panel expressions showed statistically significant (p < 0.05) frequency differences between ECA and EMA tumors. Although the additional ancillary PR-marker also revealed a significant frequency difference (p < 0.05) between ECA and EMA tumors, it did not demonstrate any supplementary benefit to the 3-marker panel.
  
  
  CONCLUSIONS
  According to our data, when histomorphological and clinical doubt exists as to the primary site of origin, we recommend that the conventional 3-marker (ER/Vim/CEA) panel is easier, sufficient and appropriate to use in distinguishing between primary ECA and EMA. Although the 4-marker panel containing PR also reveals statistically significant results, the PR-marker offers no supplemental benefit to the pre-existing 3-marker (ER/Vim/CEA) panel in the diagnostic distinction between ECA and EMA.
authors.affiliation: Department of Obstetrics and Gynecology, Chung-Shan Medical University Hospital, Taichung, Taiwan. cvs156@hotmail.com
authors.forename: Chiung-Ling
authors.initials: CL
authors.lastname: Liao
authors.forename: Ming-Yung
authors.initials: MY
authors.lastname: Lee
authors.forename: Yeu-Sheng
authors.initials: YS
authors.lastname: Tyan
authors.forename: Lai-Fong
authors.initials: LF
authors.lastname: Kok
authors.forename: Tina S
authors.initials: TS
authors.lastname: Wu
authors.forename: Chiew-Loon
authors.initials: CL
authors.lastname: Koo
authors.forename: Po-Hui
authors.initials: PH
authors.lastname: Wang
authors.forename: Kuan-Chong
authors.initials: KC
authors.lastname: Chao
authors.forename: Chih-Ping
authors.initials: CP
authors.lastname: Han
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism*; D002272:Carcinoembryonic Antigen / Q000378:metabolism*; D003937:Diagnosis, Differential; D016889:Endometrial Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D011960:Receptors, Estrogen / Q000378:metabolism*; D011980:Receptors, Progesterone / Q000378:metabolism*; D012680:Sensitivity and Specificity; D046888:Tissue Array Analysis; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology; D014746:Vimentin / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D014746:Vimentin