Quantitative Differences in Levels of Immunohistochemical Biomarkers between Squamous Cell Carcinoma and Adenocarcinoma of the Uterine Cervix: Implications for Treatment Outcomes after Chemoradiotherapy

Author(s): Rui-Yun Chen, Ji-An Liang, Yao-Ching Hung, Lian-Shung Yeh, Wei-Chun Chang, Wu-Chou Lin, Shang-Wen Chen, Yin-Yi Chang, Ying-Chun Lin

This study compared the quantitative differences in immunohistochemical markers between uterine cervical Squamous Cell Carcinoma (SCC) and Adenocarcinoma (AC) and assessed the impact of these biomarkers on outcomes in patients treated with Chemoradiotherapy (CRT). This retrospective study included 118 patients (SCC in 76, AC in 42) who received definitive CRT. According to the International Federation of Gynecology and Obstetrics staging system, 14, 34, and 70 patients were classified as having stage IB3, II, and III disease, respectively. Baseline immunohistochemical biomarkers, including hypoxia, cell proliferation, cell adhesion, immunogenicity, inflammatory, and evasion of apoptosis biomarkers, were analyzed using tissue microarrays from biopsy specimens. The Mann-Whitney U test was carried out for quantitative analysis between SCC and AC. Cox regression analysis was used to examine the effects of the biomarkers and clinical parameters on treatment outcomes. Using the H-scores of the biomarkers for SCC as a reference, increased expression of E-cadherin, calretinin, CAIX, and c-Myc and decreased levels of VEGF, tumor necrosis factor-α, galectin-9, chemokine ligand 5, Bax, EGFR, and insulin-like growth factor 1 receptor were found in the patients with AC. A high E-cadherin (P = 0.002) and low Bax (P = 0.001) H-score were associated with inferior pelvic relapse-free survival. Cervical SCC exhibited strong expression of baseline immunohistochemical inflammatory and angiogenesis biomarkers whereas the intensity of cell adhesion markers was more distinct in cervical AC. A high E-cadherin and a low Bax H-score were associated with a high rate of local relapse.

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