The expression of epithelial specific antigen in cervical intraepithelial neoplasia and adenocarcinoma

There is a spectrum of changes described as cervical glandular intraepithelial neoplasia (CGIN) with adenocarcinoma in situ (AIS) considered to represent the most severe lesion in that spectrum. Although there is evidence to suggest a progression of CGIN to AIS and to invasive adenocarcinoma, the natural history of these potential precursor lesions has not been fully elucidated. The aim of this project was to establish the relationship of endocervical glandular intraepithelial neoplasias to uterine endocervical adenocarcinoma. Our study included 40 cases of glandular lesions of the cervix (15 cases of endocervical glandular intraepithelial neoplasia, eight of adenocarcinoma in situ and 17 cases of invasive adenocarcinoma). An attempt was made to examine the immunohistochemical localization of epithelial specific antigen (ESA) in those lesions and compare the results with ten cases of normal endocervical epithelium. ESA showed positive staining of the basolateral membrane of endocervical cells in the normal endocervix. The expression of ESA was found to increase from the basolateral to the diffuse cytoplasmic membrane in 12 out of 15 cases of CGIN (80%), in seven out of eight cases of AIS (84%) and in all of the 17 invasive adenocarcinomas (100%). This finding indicates that ESA is a useful marker in the diagnosis of glandular intraepithelial neoplasia and suggests that CGIN and AIS may be precursor lesions of cervical adenocarcinoma.

Cervical glandular intraepithelial neoplasia; Epithelial specific antigen; Adenocarcinoma

[1] Parazzini F., La Vecchia C .: "Epidemiology of adenocarcinoma of the cervix". Gynecol. Oneal., 1990, 39, 40.

[2] Korhonen M.O.: "Adenocarcinoma of the uterine cervix: an evaluation of the available diagnostic methods". Acra Pathol. Micro bial. Scand. (A), 1978, 264, 3.

[3] Hurlimann J., Gloor E .: "Adenocarcinoma in situ and invasive adenocarcinoma of the uterine cervix - an immunohistologic study with antibodies specific for several epithelial markers". Cancer, 1984, 54, 103.

[4] Nanbu Y., Fujii S., Konishi I., Nonogaki H., Mori T.: "Imrnunohistochemical localization of CA-125, CEA and CA 19-9 in normal and neoplastic glandular cells of the uterine cervix" Cancer, 1988, 62, 2580.

[5] Lee K .R., Flynn C.E.: "Early invasive adenocarcinoma of the cervix: A histopathologic analysis of 40 cases with observations concerning histogenesis". Cancer , 2000, 89, 1048.

[6] Urnezaki K ., Sanezurni M., Okada H., Okamura A ., Tsubra A., Kanazaki H .: "Distribution of epithelial-specific antigen in uterine cervix with endocervical glandular dysplasia". Gynecol. Oneal., 1997, 66, 393.

[7] Tsubra A ., Senzaki H., Sasaki M., Hilgers J., Morii S.: "Irnrnunohistochemical demonstration of breast-derived and/or carcinoma associated glycoproteins in normal skin appendage and their tumors". J. Curan. Parhol., 1992, 19, 73.

[8] Brown L.J .R ., Griffin W.R., Wells M .: " Cytoplasmic reactivity with the monoclonal antibody HMFG J as a marker of cervical glandular atypia". J. Pathol., 1987, 151, 203.

[9] Helper T.K., Dockerty M.B., Randall L.M.: "Primary adenocarcinoma of the cervix". Am. J. Obstet. Gynecol., 1952, 63, 800.

[10] Stewart F.W.: "Factors influencing curability of Cancer". In: ConFerence Proceedings of the Third National Cancer Conference. Philadelphia J.B . Lippincott 1957, 62.

[11] Jaworski R.C., Pacey N.F., Greenberg M.L., Osborn R.A.: "The histologic diagnosis of adenocarcinoma is situ and related lesions of the cervix uteri. Adenocarcinoma in situ". Cance,; 1988, 61, 1171.

[12] Holowaty P., Miller A.B., Rohan T., To T.: "Natural history of dysplasia of the uterine cervix". J. Natl. Cancer Inst., 1999, 91 (3), 252.

[13] Jaworski R.C.: "Endocervical dysplasia, adenocarcinoma in situ and early invasive (rnicroinvasive) adenocarcinorna of the cervix" Sem. in Diagn. Pathol., 1990, 7, 190.