Association of syndecan-1 with tumor grade and histology in primary invasive cervical carcinoma

Objectives. The expression of syndecan-1, a cell surface heparan sulfate pr oteoglycan, is reduced during malignant transformation of squamous cells. S tudies on squamous cell carcinoma of the head and neck have shown that synd ecan-1-positive tumors are associated with longer overall and recurrence-fr ee survival. The purpose of this study was to analyze syndecan-1 expression in invasive cervical carcinoma and to examine the association of syndecan- 1 expression with prognostic factors and overall survival. Methods. The study population consisted of 124 patients treated for primary invasive carcinoma of the uterine cervix at the Turku University Central H ospital during the years 1970-1988. The material consisted of 102 (82.3%) s quamous cell carcinomas, 16 (12.9%) adenocarcinomas and 1 (0.8%) adenosquam ous carcinoma, 1(0.8%) small cell carcinoma, 1 (0.8%) adenoid basal carcino ma, 1 (0.8%) carcinosarcoma, and 2 (1.6%) unclassified cervical carcinomas. Syndecan-1 expression was determined on paraffin-embedded tissue blocks us ing a human syndecan-1-specific monoclonal antibody B-B4 and immunohistoche mistry. The expression of syndecan-1 was classified according to staining i ntensity as well as the percentage of positively stained tumor cells. Results. Staining intensity was strong in 44 (36%) samples, while 24 (19%) specimens remained syndecan-1-negative. In 49 (40%) samples, the percentage of syndecan-1-positive cells was greater than or equal to 90%. Syndecan-1 expression, as determined by greater than or equal to 50% positively staine d tumor cells, was associated with the grade of differentiation (P = 0.03) and squamous histology (P < 0.001), but was not associated with clinical st age (P = 0.16) or disease-free survival (P = 0.86). Age (P = 0.003) and cli nical stage (P < 0.001) were significant prognostic factors, but syndecan-1 expression determined neither by percentage of positively stained tumor ce lls nor by staining intensity was associated with the outcome. Conclusions. In cervical carcinoma syndecan-1 is associated with histologic al differentiation grade and squamous histology, but does not predict clini cal outcome. (C) 1999 Academic Press.