American Journal of Medical and Clinical Sciences. 2017; 2(1):(8-74)


Combined expressions of ALEX1 and HNF-1β could improve the ability of differentiation between squamous cell carcinoma and adenocarcinoma of the uterine-cervix

Hanaa A. Atwa, Mona Saeed Mohamed

Abstract
Objective: Differentiation between poorly differentiated cervical squamous cell carcinoma (SCC) & adenocarcinoma which is essential for proper therapy, by histopathology alone can be confusing. Immunohistochemistry can aid important data to diagnosis. The transcription factor hepatocyte-nuclear-factor-1-beta (HNF-1β) essentially participates in the visceral-endoderm differentiation from the primitive-endoderm. Arm-protein-lost-in-epithelial-cancers-on-chromosome X (ALEX) is a recent subtype of armadillo- families that had arm-repeat-domains, detected on chromosome-X. The goal of our research: was to explore the diagnostic roles of HNF-β and ALEX-1 protein expressions, in differentiation between adenocarcinoma and squamous-cell-carcinoma of the cervix using immunehistochemical method.
Methods: HNF-1-β and ALEX-1 protein expressions were evaluated in 32 cases of SCC and 18 cases of adenocarcinoma of the cervix. The relationships between their levels of expression and the ability of panel of both markers in differentiation between both types of carcinomas were analyzed.
Results: We observed positive staining for HNF-1β in 83.4% (15/18) of adenocarcinoma cases. The difference of HNF-1β expression between cervical SCC and adenocarcinoma was statistically significant (p < 0.001). Positive ALEX-1 expression was observed in all cases of SCC of the cervix. The difference of ALEX-1expression between cervical SCC and adenocarcinoma was statistically significant (p < 0.001). This methodology for distinguishing cervical squamous cell carcinoma and adenocarcinoma had a sensitivity of 93.8% and a specificity of 100% (p < 0.001). Conclusion: The panel of both HNF-1β and ALEX-1 expressions can help in proper subtyping of cervical carcinoma with high sensitivity and specificity.
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