Correlation between invasive pattern and immunophenotypic alterations in endocervical adenocarcinoma

Aims: To assess the immunophenotypic changes associated with epithelial-mesenchymal transition (EMT) in endocervical adenocarcinoma, and correlate the findings with tumour morphology including growth pattern. Methods and results: Twenty-seven endocervical adenocarcinomas were studied using a panel of immunohistochemical markers to vimentin, cyclin D1, E-cadherin, beta-catenin, p16 protein and cytokeratin 7. There were 24 moderately differentiated and three poorly differentiated tumours. Fourteen of the moderately differentiated carcinomas showed a focal infiltrative component, typically towards the deep tumour margin (invasive front), comprising attenuated glands, small cell clusters and single cells. These foci typically showed cytological alteration including loss of cellular polarity and cytoplasmic eosinophilia, while immunohistochemistry demonstrated reduced cell membrane E-cadherin and beta catenin labelling, and expression of cyclin D1 and, in some cases, vimentin. Similar immunophenotypic changes were focally observed at the deep aspect of some larger 'conventional' tumour glands. No consistent changes were observed in the poorly differentiated carcinomas. Conclusions: Endocervical adenocarcinomas that demonstrate an infiltrative growth pattern show immunophenotypic changes consistent with EMT. Frequently, these are accompanied by a morphological alteration in the tumour cells and the changes exhibit a specific micro-anatomical distribution. Epithelial-mesenchymal transition may represent an important mechanism in the progression of some endocervical neoplasms.