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Correlation between HPV PCNA, p16, and p21 Expression in Lung Cancer Patients. Cell Microbiol 2022. [DOI: 10.1155/2022/9144334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. Evaluate if human papillomavirus (HPV) infection in lung cancer patients might be helping cancer development by altering p16, p21, and PCNA, key human genes involved in cell proliferation and tumor development. Methods. 63 fresh-frozen (FF) and formalin-fixed paraffin-embedded (FFPE) samples from lung tumor patients were used to detect HPV by PCR, followed by genotype through sequencing. The host gene expressions of p21, p16, and PCNA were quantified by qPCR in both FF and FFPE samples, and the expression of viral oncogenes E5, E6, and E7 was also measured by qPCR in 19 FF samples. Results. 74.6% of samples were positive for HPV, 33/44 FFPE samples and 14/19 FF samples. HPV-16 and HPV-18 were detected in 31/33 and 7/33 FFPE, respectively, and HPV-16 was the only type in FF samples. E5, E6, and E7 were expressed in 10/19, 2/19, and 4/19 FF samples, respectively. The p16 RNAm expression was higher in FF HPV+ samples and FFPE+FF HPV+ samples, while p21 showed higher expression in all HPV- samples. In turn, the PCNA expression was higher in HPV+ FF samples; however, in FFPE and FFPE+FF samples, PCNA was higher in HPV- samples. In FF samples, PCNA, p16, and p21 showed a significant positive correlation as well as E5 and E7, and E5 was inversely correlated to p21. In FFPE, also, a positive correlation was observed between PCNA HPV+ and p21 HPV+ and PCNA HPV+ and p16 HPV. In FF+FFPE analysis, a direct correlation was found between PCNA HPV+ and p21 HPV+, p21 HPV+ and p16 HPV+, and PCNA HPV- and p16 HPV-, and an inverse correlation between PCNA HPV+ and p16 HPV+. Also, the p16 protein was positive in 10 HPV+ samples and 1 HPV-. Conclusions. Our data show that lung cancer patients from Northeast Brazil have a high prevalence of HPV, and the virus also expresses its oncogenes and correlates with key human genes involved in tumor development. This data could instigate the development of studies focused on preventive strategies, such as vaccination, used as a prognostic indicator and/or individualized therapy.
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Xu LJ, Cai J, Huang BX, Dong WH. Locally advanced cervical rhabdomyosarcoma in adults: A case report. World J Clin Cases 2022; 10:9454-9461. [PMID: 36159439 PMCID: PMC9477661 DOI: 10.12998/wjcc.v10.i26.9454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/04/2022] [Accepted: 08/05/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Rhabdomyosarcoma is a soft tissue tumor of primitive mesenchymal cells origin, occurring predominantly in children and adolescents, but extremely rare in adults and the data regarding its treatment are sparse. Here, we would like to share our experience in the treatment of a locally advanced primary embryonal rhabdomyosarcoma of cervix in a 39-year-old female.
CASE SUMMARY The patient was admitted with symptoms of intermenstrual bleeding and postcoital bleeding for six months. Physical examination revealed a friable, polyp-like mass (5 cm × 5 cm) in her cervix protruding into the vagina, while the uterus was mobile and normal-sized. Colposcopy-directed biopsy was performed, and a pathological diagnosis of embryonal rhabdomyosarcoma was made. Magnetic resonance imaging of the pelvis showed that the cervical volume was significantly increased, with a hypointense and hyperintense soft tissue mass on the right side, invading the cervical stroma; the mass was 5 cm × 5 cm with a clear boundary and confined to the cervix; there were no obvious findings indicating tumor invasion in the vaginal wall, parametrium, or pelvic wall; no enlarged lymph nodes were observed in the pelvic cavity. Based on our findings, the tumor was classified as stage IA according to the intergroup rhabdomyosarcoma studies criteria and IB3 stage according to The International Federation of Gynecology and Obstetrics 2018. The patient underwent two courses of neoadjuvant chemotherapy and a partial remission was achieved. Subsequently, she underwent laparoscopic radical hysterectomy, bilateral salpingo-oophrectomy and pelvic lymph node dissection and there were no risk factors revealed by postoperative pathological examination. Adjuvant chemotherapy was performed after surgery. The patient was disease-free until the last follow-up, 49 mo after completing the entire treatment.
CONCLUSION Our experience suggests that neoadjuvant vincristine, dactinomycin, and cyclophosphamide chemotherapy followed by radical surgery and adjuvant chemotherapy might be reasonable therapeutic option for bulky cervical rhabdomyosarcoma in adults without fertility desire. Since large-scale studies on such rare conditions are rather impossible, further case reports and systematic reviews could help optimize the treatment of primary, bulky cervical rhabdomyosarcoma in adults.
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Affiliation(s)
- Lin-Juan Xu
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Cai
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bang-Xing Huang
- Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Wei-Hong Dong
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Xu H, Zhao Z, Zhu Y. Clinicopathologic features and lymph node metastasis pattern of the cervical MiNEN. Endocrine 2022; 76:474-483. [PMID: 35102503 DOI: 10.1007/s12020-022-02992-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 01/21/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) is a rare type of cervical tumor. Its clinicopathological features, lymph node (LN) metastatic patterns and outcomes are still unclear. METHODS We have analyzed the clinicopathological information of 26 patients with cervical MiNEN. RESULTS The median age of onset for cervical MiNEN was 48 years. Macroscopically, polyps and nodules were the main types. The neuroendocrine components included small cell neuroendocrine carcinoma (SCNEC) (14/26 cases), large cell neuroendocrine carcinoma (LCNEC) (10/26 cases), and typical carcinoid (2/26 cases). Non-neuroendocrine components included adenocarcinoma (AC) (12/26, including one case of AC in situ) and squamous cell carcinoma (SC) (10/26) and adeno-squamous cell carcinoma (ASC) (4/26). Of the 16 AC cases, 15 were human papilloma virus (HPV)-associated AC and one was HPV-independent AC. Except for the case of MiNEN with HPV-independent AC, all cases were diffusely and strongly positive for p16 protein. The lympho-vascular space invasion (LVSI) was seen in 17/26 cases, and the components that invade lymphatic vessels were mainly neuroendocrine carcinomas (NECs) (15/17), followed by SC (1/17) and AC (1/17). Ten patients developed LN metastases, including six in combined SCNECs (6/14) and four in combined LCNECs (4/10); the metastatic component was pure NEC in eight cases (8/10) and SC or AC in two cases (2/10). CONCLUSIONS NEC component is the key factor that determines the clinical behavior and prognosis of cervical MiNEN.
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Affiliation(s)
- Huihui Xu
- Department of Pathology, Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Zehua Zhao
- Department of Pathology, Cancer Hospital of Dalian University of Technology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Yanmei Zhu
- Department of Pathology, Cancer Hospital of Dalian University of Technology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China.
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Mullen C, Beverstock S, Roddie H, Campbell V, Al-Qsous W. Myeloid sarcoma of uterine cervix: A case report with review of the literature. Gynecol Oncol Rep 2022; 39:100931. [PMID: 35106356 PMCID: PMC8784329 DOI: 10.1016/j.gore.2022.100931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/10/2022] [Indexed: 11/23/2022] Open
Abstract
Myeloid sarcoma of uterine cervix is very uncommon and can be the initial presentation of acute myeloid leukaemia. Myeloid sarcoma can mimic other malignant tumours arising in the cervix and can therefore pose a diagnostic challenge. Myeloid sarcoma should be considered in the differential diagnosis of undifferentiated malignant tumours arising in the gynaecological tract.
Myeloid sarcoma is a rare clinical entity, characterised by the extramedullary presence of myeloblasts. It can occur de novo or signify disease recurrence. Involvement of the female reproductive tract is uncommon, with most cases involving the uterine corpus or ovary. Patients with non-leukaemic myeloid sarcoma are treated with acute myeloid leukaemia (AML) regimens, but the optimal therapy is unclear due to the relative rarity of the condition and lack of clinical trial data. We present an unusual case of myeloid sarcoma of the uterine cervix diagnosed incidentally in a patient with cervical-intraepithelial neoplasia grade 2 (CIN2), followed by a literature review.
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Affiliation(s)
- C. Mullen
- Department of Haematology, Western General Hospital, Edinburgh, United Kingdom
| | - S. Beverstock
- Department of Haematology, Western General Hospital, Edinburgh, United Kingdom
| | - H. Roddie
- Department of Haematology, Western General Hospital, Edinburgh, United Kingdom
| | - V.L. Campbell
- Department of Haematology, Western General Hospital, Edinburgh, United Kingdom
| | - W. Al-Qsous
- Department of Pathology, Western General Hospital, Edinburgh, United Kingdom
- Corresponding author at: Department of Pathology, Alexander Donald Building, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, United Kingdom.
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Rivera-Colón G, Zheng W. Endocervical neoplasia: Pathologic updates in diagnosis and prognosis. Semin Diagn Pathol 2021; 39:213-227. [DOI: 10.1053/j.semdp.2021.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 12/16/2021] [Indexed: 11/11/2022]
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Haight PJ, Castaneda AV, Savage JM, Copeland LJ. Cervical carcinoma with histologic components of sarcomatoid carcinoma and multiple basaloid variants: A case report and review of the literature. Gynecol Oncol Rep 2021; 37:100797. [PMID: 34124329 PMCID: PMC8173268 DOI: 10.1016/j.gore.2021.100797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/13/2021] [Accepted: 05/21/2021] [Indexed: 11/15/2022] Open
Abstract
Basaloid cervical tumors are well-documented histologic variants and rarely exist in pure forms. Sarcomatoid carcinoma of the cervix is not yet classified as a histologic variant by the WHO. Squamous cell, basaloid and sarcomatoid carcinoma within a single cervical specimen is rare.
Cervical cancer with co-existing pathologic components of squamous cell carcinoma, basaloid morphology and sarcomatoid carcinoma is rare, with limited reports in the literature. Here we present a patient who underwent a modified radical hysterectomy for cervical cancer, with final pathology specimen demonstrating multiple histologic variants including basal carcinoma, adenoid cystic-like areas, basaloid squamous cell carcinoma and areas of high-grade transformation to sarcomatoid carcinoma.
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Affiliation(s)
- Paulina J Haight
- Division of Gynecologic Oncology, The Ohio State University Wexner Medical Center, M210 Starling Loving Hall, 320 W 10 Avenue, Columbus, OH 43210, United States
| | - Antonio V Castaneda
- Division of Gynecologic Oncology, The Ohio State University Wexner Medical Center, M210 Starling Loving Hall, 320 W 10 Avenue, Columbus, OH 43210, United States
| | - Johanna M Savage
- Division of Pathology, The Ohio State University Wexner Medical Center, S305E Rhodes Hall, 410 W 10 Avenue, Columbus, OH 43210, United States
| | - Larry J Copeland
- Division of Gynecologic Oncology, The Ohio State University Wexner Medical Center, M210 Starling Loving Hall, 320 W 10 Avenue, Columbus, OH 43210, United States
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Winer I, Kim C, Gehrig P. Neuroendocrine tumors of the gynecologic tract update. Gynecol Oncol 2021; 162:210-219. [PMID: 34023130 DOI: 10.1016/j.ygyno.2021.04.039] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/29/2021] [Indexed: 10/21/2022]
Affiliation(s)
- I Winer
- Division of Gynecologic Oncology, Department of Oncology, Wayne State University, Detroit, MI, USA.
| | - C Kim
- New York Cancer Blood Specialists, Patchogue, NY, USA; Division of Hematology/Oncology, Department of Medicine, Stony Brook University Hospital, Stony Brook, NY, USA
| | - P Gehrig
- Department of Obstetrics & Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
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The Usefulness of Immunohistochemistry in the Differential Diagnosis of Lesions Originating from the Myometrium. Int J Mol Sci 2019; 20:ijms20051136. [PMID: 30845657 PMCID: PMC6429074 DOI: 10.3390/ijms20051136] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/20/2019] [Accepted: 03/01/2019] [Indexed: 12/15/2022] Open
Abstract
Uterine leiomyomas (LMs), currently the most common gynecological complaint around the world, are a serious medical, social and economic problem. Accurate diagnosis is the necessary prerequisite of the diagnostic-therapeutic process. Statistically, mistakes may occur more often in case of disease entities with high prevalence rates. Histopathology, based on increasingly advanced immunohistochemistry methods, is routinely used in the diagnosis of neoplastic diseases. Markers of the highest sensitivity and specificity profiles are used in the process. As far as LMs are concerned, the crux of the matter is to identify patients with seemingly benign lesions which turn out to be suspicious (e.g., atypical LM) or malignant (e.g., leiomyosarcoma (LMS)), which is not uncommon. In this study, we present the current state of knowledge about the use of immunohistochemical markers in the differential diagnosis of LM, atypical LM, smooth muscle tumors of uncertain malignant potential (STUMP), and LMS, as well as their clinical predictive value.
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Missaoui N, Salhi S, Bdioui A, Mestiri S, Abdessayed N, Mokni M, Yacoubi MT. Immunohistochemical Characterization Improves the Reproducibility of the Histological Diagnosis of Ovarian Carcinoma. Asian Pac J Cancer Prev 2018; 19:2545-2551. [PMID: 30256049 PMCID: PMC6249481 DOI: 10.22034/apjcp.2018.19.9.2545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background: Ovarian cancer is the leading cause of gynecologic cancer-related death. Histological
assessment remains the standard clue for the diagnosis of ovarian carcinoma. Misinterpretation and inconsistent
application of histological criteria may lead to significant interobserver variability and poor reproducibility of
the diagnosis. In this study, we investigated the discrepancy in histological diagnosis and the significance of a designed
panel of immunohistochemical markers for the improvement of the diagnostic reproducibility of ovarian carcinomas.
Methods: We performed a retrospective study on 74 ovarian carcinomas. All tumor slides were independently
reviewed by two pathologists. The results for seven available immunomarkers as p53, WT-1, p16INK4A, CK7,
CK20, and estrogen and progesterone receptors were determined for all cases by immunohistochemistry. Results:
The histological diagnosis review performed using standard histology showed a concordance of diagnoses in 86% of
cases with Cohen’s kappa of 0.80. Immunohistochemical results increased significantly the diagnosis reproducibility
with a concordance of 91% and a Cohen’s kappa of 0.86 (P = 0.001). Conclusion: Although the histological diagnosis
remains reliable, the use of a designed panel of immunohistochemical markers improves significantly the interobserver
concordance and the classification accuracy of ovarian carcinomas.
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Affiliation(s)
- Nabiha Missaoui
- Research Unit UR14ES17, Cancer Epidemiology and Cytopathology in Tunisian Center, Medicine Faculty of Sousse, University of Sousse, Tunisia.,Faculty of Sciences and Techniques, Sidi Bouzid, Kairouan University, Tunisia.,Pathology Department, Farhat Hached Hospital, Sousse, Tunisia.
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