Distinction Between Endometrial and Endocervical Adenocarcinoma: An Immunohistochemical Study

TLDR

The study aimed to determine whether a panel of immunohistochemical stains could differentiate primary endometrial from endocervical adenocarcinomas. They examined 29 endocervical and 30 endometrial adenocarcinomas, including cases with overlapping histology, using vimentin, CEA, EMA, CK7, and CK20 stains. Vimentin and CEA proved discriminative—97 % of endometrial tumors were VIM‑positive versus 7 % of endocervical, and CEA was positive in 62 % of endocervical versus 27 % of endometrial—while CK7, CK20, and EMA did not distinguish the two types.

Abstract

We investigated the possibility of distinguishing between primary endometrial and endocervical adenocarcinomas by using a panel of immunohistochemical stains, which included vimentin (VIM), carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA), and cytokeratins 7 and 20 (CK7 and CK20). Twenty-nine endocervical adenocarcinomas (CCAs) and 30 endometrial adenocarcinomas (EMCAs) including cases with overlapping histologic features (CCAs with endometrioid differentiation [15/29] and EMCAs with mucinous differentiation [16/30]) were evaluated. Most EMCAs (29/30, 97%) were VIM positive, whereas only 2/29 (7%) CCAs were VIM positive. The great majority of EMCAs (28/30) and all 29 CCAs were CK7 positive, whereas all 30 EMCAs and 27/29 CCAs were negative for CK20. CEA positivity was more common in CCAs (18/29, 62%) than in EMCAs (8/30, 27%). EMA positivity was present in all 30 EMCAs and in 26 of 29 (90%) CCAs. We conclude that VIM and CEA are useful immunohistochemical markers in distinguishing EMCAs and CCAs, but CK7, CK20, and EMA are not useful in this distinction.