Chavez-Blanco A, Taja-Chayeb L, Cetina L, Chanona-Vilchis G, Trejo-Becerril C, Perez-Cardenas E, Segura-Pacheco B, Acuña-González C, Dueñas-Gonzalez A
Unidad de Investigación Biomédica en Cancer, Instituto Nacional de Cancerología, UNAM, México City, México.
Int J Gynecol Pathol. 2002 Oct;21(4):368-74. doi: 10.1097/00004347-200210000-00006.
Small-cell carcinomas of the uterine cervix are highly aggressive tumors. Up to 100% of these tumors express at least one neuroendocrine marker such as neuron-specific enolase (NSE), chromogranin A (CgA), and synaptophysin (SYN). In other tumor types such as non-small-cell carcinomas of the lung, colon, and prostate, the presence of these markers has been associated with a better prognosis in some studies, a worsened prognosis in others, or has had no prognostic effect in still other studies. However, little is known about their expression and prognostic significance in the common "non-small-cell" carcinomas of the uterine cervix. The primary tumors of 54 previously untreated patients with histologically confirmed non-small-cell carcinoma of the cervix uteri (squamous carcinoma, adenosquamous carcinoma, and adenocarcinoma) were analyzed by immunohistochemistry for expression of NSE, CgA, and SYN. The expression status was correlated to pathological characteristics and outcome. In addition, the expression of these markers was investigated in cervical carcinoma cell lines. None of the 54 tumors expressed NSE or CgA, although SYN was positive in five tumors (9%) of which four were squamous and one was adenocarcinoma. These five patients relapsed within the first 6 months of follow-up and four have died. Among eight cancer cell lines only one was positive for CgA and another one for SYN. We conclude that the neuroendocrine marker SYN is expressed in a small subset of non-small-cell carcinomas of the cervix and its expression seems to correlate with a poor outcome.
子宫颈小细胞癌是极具侵袭性的肿瘤。这些肿瘤中高达100%至少表达一种神经内分泌标志物，如神经元特异性烯醇化酶（NSE）、嗜铬粒蛋白A（CgA）和突触素（SYN）。在其他肿瘤类型中，如肺癌、结肠癌和前列腺癌的非小细胞癌，在一些研究中，这些标志物的存在与较好的预后相关，在另一些研究中与较差的预后相关，而在其他一些研究中则没有预后影响。然而，对于它们在常见的子宫颈“非小细胞”癌中的表达及预后意义知之甚少。对54例先前未经治疗、组织学确诊为子宫颈非小细胞癌（鳞状细胞癌、腺鳞癌和腺癌）患者的原发性肿瘤进行免疫组织化学分析，以检测NSE、CgA和SYN的表达。将表达状态与病理特征及预后相关联。此外，还在子宫颈癌细胞系中研究了这些标志物的表达。54例肿瘤均未表达NSE或CgA，不过有5例肿瘤（9%）SYN呈阳性，其中4例为鳞状细胞癌，1例为腺癌。这5例患者在随访的前6个月内复发，4例已死亡。在8个癌细胞系中，只有1个CgA呈阳性，另1个SYN呈阳性。我们得出结论，神经内分泌标志物SYN在一小部分子宫颈非小细胞癌中表达，其表达似乎与不良预后相关。
