title: Distinguishing between primary endocervical and endometrial adenocarcinomas: is a 2-marker (Vim/CEA) panel enough?
abstract: Gynecological pathologists are used to operating many panels of various markers in combination for the diagnostic distinction between primary endocervical and endometrial adenocarcinomas. The conventional 3-marker (ER/Vim/CEA) panel is the most promising tool. In this study, our aim is to investigate whether a 2-marker panel is enough to distinguish between these two gynecologic malignancies. Additionally, we wish to determine which one is the most favorable among eight panels tested, including six 2-marker (ER/CEA, PR/CEA, Vim/CEA, ER/p16(INK4a), PR/p16(INK4a), Vim/p16(INK4a)) and two 3-marker (ER/Vim/CEA, ER/Vim/p16(INK)) panels. A tissue microarray was constructed using paraffin-embedded, formalin-fixed tissues from 35 hysterectomy specimens, including 14 primary endocervical adenocarcinomas and 21 primary endometrial adenocarcinomas. Utilizing the avidin-biotin complex (ABC) method, tissue array sections were immunostained with five commercially available antibodies (ER, Vim, CEA, PR, and p16(INK4a)) to evaluate their individual frequencies of expression. We found that all eight aforementioned panels showed an encouraging range of overall accuracy (69.2% to 78.3%). However, one panel of 2-markers (Vim, CEA) exhibited the most efficiency (78.3%) in the diagnostic distinction between primary endocervical and endometrial adenocarcinomas. Based on the analyzed data, we conclude that the 2-marker (Vim/CEA) panel seems adequate to be an appropriate, convenient, and efficient means to distinguish between primary endocervical and endometrial adenocarcinomas. Even though there were a limited number of cases, this study still provides valuable references to help avoid wasting resources and unnecessary marker testing.
authors.affiliation: Department of Obstetrics and Gynecology, Chung-Shan Medical University Hospital, Taichung, Taiwan, Republic of China.
authors.forename: Chiung-Ling
authors.initials: CL
authors.lastname: Liao
authors.forename: Jeng-Dong
authors.initials: JD
authors.lastname: Hsu
authors.forename: Ming-Yung
authors.initials: MY
authors.lastname: Lee
authors.forename: Lai-Fong
authors.initials: LF
authors.lastname: Kok
authors.forename: Yi-Ju
authors.initials: YJ
authors.lastname: Li
authors.forename: Po-Hui
authors.initials: PH
authors.lastname: Wang
authors.forename: Chung-Chin
authors.initials: CC
authors.lastname: Yao
authors.forename: Chih-Ping
authors.initials: CP
authors.lastname: Han
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002272:Carcinoembryonic Antigen / Q000378:metabolism*; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000378:metabolism; D003937:Diagnosis, Differential; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D040081:Protein Array Analysis / Q000379:methods; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D014746:Vimentin / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D019941:Cyclin-Dependent Kinase Inhibitor p16; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D014746:Vimentin