Study Of Expression Of Some Proteins And Mucus Composition In Minimal Deviation Adenocarcinoma In Cervix

ObjectiveMinimal deviation adenocarcinoma(MDA) of cervix is a kind of rare high-grade adenocarcinoma.It is often misdiagnosed and undiagnosed because of its mild atypia.Combined with clinical pathological parameter,immunohistochemical method and specific staining were used to evaluate the expression of some proteins and mucus composition in MDA. To study index which can make for the diagnosis of cervical MDA and provide objective foundation for its early diagnosis and clinical therapy.MethodsImmunohistochemical EnvisionTM two-step method was used to evaluate the expression of CEA,Ki-67,P16,MUC6,MUC5AC,ER,PR,α-SMA in 9 samples of MDA with AB-PAS,HID-AB staining to study mucus composition.In contrast,we also selected 12 normal cervical glands ,21 other types of cervical denocarcinomas(18 endocervical adenos,2 endometrioid adenos,1 clear cell adenos) and 10 cervical gland dysplasia. Statistics analysis was undertaken combined with clinical feature.Results1.The expression of CEA,Ki-67,MUC6,α-SMA protein in MDA was higher than that expression of normal cervical gland.But as to the expression of ER,PR,the former was lower than the latter.All the significant differences were observed(P<0.05). The expression of P16,MUC5AC had no statistics significance in MDA and normal tissue(P>0.1).2.The expression of MUC6 protein in MDA was higher than that expression of other types of adenocarcinomas,with the expression of P16 lower than the latter.All the significant differences were observed(P<0.01). The expression of CEA,Ki-67,MUC5AC,ER,PR,α-SMA had no statistics significance in MDA and other types of adenocarcinomas(P>0.05).3.AB-PAS staining revealed that in all 9 MDAs,the tumor cell cytoplasm was stained predominantly red by PAS,with AB-positive cells distributed only sparsely.The cytoplasm of the constituent cells in all 12 normal cervical glands was stained entirely purple or violet.In 21 other adenocarcinomas,there was one sample of which the staining pattern with AB-PAS was the same as that in MDA.The tumor cells of 20 remain adenocarcinoma glands were also stained purple or violet.4.HID-AB staining revealed that in all 12 normal cervical glands there were both black-stained sites and blue-stained sites with the former predominant.In 9 cases of MDA,the amount of two staining was decreased with the cytoplasm of some tumor cells stained lighe blue.Staining pattern of 21 other types of adenocarcimomas was shown by HID-AB to consist predominantly of black-stained in 14 adenocarcinomas and blue-stained in 7.5.In 10 cervical gland dysplasia,two samples expressed Ki-67 and two P16.Conclusions1.Immunohistochemical detection of CEA,Ki-67,MUC6,α-SMA perhaps make for the diagnosis of cervical MDA.The abensence of ER,PR of gland cells also support MDA.2.Abnormal expression of P16 gene is perhaps the early molecular event of multi-steps process of cervical adenocarcinomas which plays an important role in genesis and development of some conventional adenocarcinomas.But perhaps not in MDA.3.Both acid and neutral mucus are shown to exist equally by AB-PAS in normal cervical glands.MDA cells produce neutral mucus almost exclusively.In other types of adenocarcinomas,mixed mucus is still predominant.4.In normal cervical glands there are both sulfomucin and sialomucin with the former predominantly.In MDA,the amount of acid mucin is decreased with sialomucin predominant. Staining pattern of other types of adenocarcimomas is shown by HID-AB to consist predominantly of sulfomucin in some adenocarcinomas and sialomucin in others.5.Overexpression of MUC6 and result of AB-PAS staining indicate that MDA perhaps develops from gastric metaplasia or there is at least abnormal expression of mucin gene.But another gastric mucin MUC5AC is also shown in normal cervical gland.