EXPRESSION OF CYTOKERATIN-10,13, AND INVOLUCRIN AS PROGNOSTIC FACTORSIN LOW STAGE SQUAMOUS-CELL CARCINOMA OF THE UTERINE CERVIX

Background. The identification of pretreatment markers with predictive significance for the presence of lymph node metastases and treatment outcome in low stage cancer of the uterine cervix is clinically import ant. Because the presence of differentiation-related markers varies in this type of cancer, the authors investigated whether loss of these m arkers is related to a poor clinical course. Methods. An indirect immu noperoxidase technique was applied to formalin fixed, paraffin embedde d tissue sections of 80 patients with International Federation of Gyne cology and Obstetrics Stage IB and IIA primary squamous cell cervical carcinomas for detection of expression of cytokeratin 10 and 13, and i nvolucrin. Comparisons were made of the expression of each of these ma rkers among 40 patients with regional node metastases and and 40 age-m atched patients with no lymph node metastases. Differences in the freq uency of expression of these markers also were analyzed in relation to histopathologic characteristics, recurrence, and survival. Results. E xpression of cytokeratin 10, 13, and involucrin was found in 24, 64, a nd 53%, respectively, of all patients studied. The authors found no di fferences between patients with positive regional lymph nodes and thos e with negative lymph nodes. Expression of cytokeratin 13 and involucr in was associated with tumor grade (P = 0.01). No relationship was fou nd between expression of the markers used and recurrence or survival i n the entire group. Within the lymph node-positive group, however, the survival rate of patients with tumors with cytokeratin 13 expression was significantly higher than that of patients with tumors lacking cyt okeratin 13 expression (P = 0.02). Conclusions. Expression of cytokera tin 10, 13, or involucrin in the primary tumor is of no predictive val ue with respect to the presence of regional lymph node metastases in l ow stage squamous cell cervical cancer. However, cytokeratin 13 expres sion appears to be of prognostic significance in patients with positiv e regional lymph nodes.