EXPRESSION AND PROGNOSTIC-SIGNIFICANCE OF ESTROGEN AND PROGESTERONE RECEPTORS IN ADENOCARCINOMA OF THE UTERINE CERVIX

Background. Adenocarcinoma of the uterine cervix typically is an aggre ssive neoplasm with a propensity for early invasion and dissemination. Little data are available correlating histologic, histochemical, or i mmunocytochemical parameters with the biologic behavior of this neopla sm. Specifically, the implication of expression of estrogen and proges terone receptors in cervical adenocarcinoma is essentially undefined. Methods. An immunocytochemical hormone receptor assay using specific m onoclonal antibodies against estrogen receptors (ER) and progesterone receptors (PgR) was used to study paraffin-embedded specimens from 54 patients with primary cervical adenocarcinomas. The specimens were eva luated for heterogeneity and intensity of staining. An attempt also wa s made to study the relationship between the pattern of hormone recept or expression and other established prognostic indicators. Results. In all patients, diffuse positive staining of benign endocervical epithe lial or stromal cells was observed. Positive immunostaining was seen i n the adenocarcinoma specimens of 16 of 54 (30%) patients for ER and 1 9 of 54 (35%) patients for PgR. Expression of ER and PgR statistically correlated with each other (P = 0.0001). Endocervical-type adenocarci noma had the highest degree of staining for both ER and PgR. Clear cel l carcinomas and intestinal-type carcinomas were negative for both rec eptors. Positivity for ER and PgR inversely correlated with histologic grade as defined by the International Federation of Gynecology and Ob stetrics (FIGO). The relationship between hormone receptor expression and FIGO stage was not statistically significant. Survival was associa ted with clinical stage (P = 0.004) and with immunocytochemical status of ER expression (P = 0.032) and PgR expression (P = 0.009). Conclusi ons. This study of 54 specimens from patients with cervical adenocarci noma suggests that positive expression of ER and PgR is associated wit h prolonged survival.