Cervical intraepithelial neoplasia (CIN) 3-like squamous cell carcinoma of the cervix: a review of 14 cases with comparison of E-cadherin and cyclin D1 expression in the CIN 3-like and infiltrative tumour elements.
OBJECTIVE
To review the clinicopathological features of 14 cases of CIN 3-like squamous cell carcinoma (SCC) of the cervix and to investigate possible mechanisms of tumour invasion in the CIN 3-like and 'conventional' (infiltrative) tumour components.


RESULTS
The median patient age was 43.4 years. Of the 12 cases with known stage, eight were stage IB and four were stage II. Initial biopsies were often misinterpreted as CIN 3 alone or CIN 3 with only superficial stromal invasion, and eight patients underwent multiple biopsy procedures prior to definitive diagnosis: upon review, an earlier diagnosis was possible in six of these cases. Nine tumours exhibited both CIN 3-like and conventional tumour components. The former usually demonstrated an E-cadherin-positive and cyclin D1-negative immunophenotype, whereas conventional SCC more often showed loss of E-cadherin and cyclin D1 staining at the margin of larger tumour nests and in smaller invasive clusters.


CONCLUSIONS
Cervical SCCs demonstrating a CIN 3-like growth pattern continue to present diagnostic difficulty and are often misinterpreted as non-invasive/minimally invasive disease. The morphology and immunophenotype suggest a process of collective cellular invasion in CIN 3-like SCC, whereas corresponding conventional SCC elements show features consistent with epithelial-mesenchymal transition.
Department of Pathology, King Edward Memorial Hospital, Perth, Western Australia, Australia.|School of Womens' and Infant's Health, University of Western Australia, Perth, Western Australia, Australia.
Colin J R
CJ
Stewart
Department of Pathology, King Edward Memorial Hospital, Perth, Western Australia, Australia.
Maxine L
ML
Crook
D000328:Adult; D000368:Aged; D015703:Antigens, CD; D014408:Biomarkers, Tumor / Q000032:analysis; D015820:Cadherins / Q000032:analysis / Q000096:biosynthesis*; D002294:Carcinoma, Squamous Cell / Q000378:metabolism / Q000473:pathology*; D019938:Cyclin D1 / Q000032:analysis / Q000096:biosynthesis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D002583:Uterine Cervical Neoplasms / Q000378:metabolism; D002578:Uterine Cervical Dysplasia / Q000378:metabolism / Q000473:pathology*
D015703:Antigens, CD; D014408:Biomarkers, Tumor; C530104:CCND1 protein, human; C513384:CDH1 protein, human; D015820:Cadherins; D019938:Cyclin D1
CIN 3-like; E-cadherin; cervix; cyclin D1; squamous carcinoma