beta-catenin expression as a prognostic indicator in cervical adenocarcinoma

The purpose of this study was to assess the prognostic influence of beta -c atenin expression by immuno-histochemistry in patients with cervical adenoc arcinomas. The study group comprised of 51 patients who underwent total hys terectomy for cervical cancer. The median follow-up was 39 months (range 1- 138 months). beta -catenin was expressed strongly on the membranes of norma l cervical epithelial and glandular cells. Uniform membranous Bcatenin stai ning localized to intercellular borders was observed in 35% of tumors, wher eas 65% of tumors demonstrated an abnormal pattern of reduced or aberrant b eta -catenin expression (i.e., cytoplasmic and/or nuclear staining patterns ). Abnormal beta -catenin immunoreactivity was associated statistically wit h advanced pathologic stage (p=0.018). The 10-year disease-free survival wa s 51.0% in patients with preserved expression of beta -catenin. On the othe r hand, a poorer prognosis was noted in the group with abnormal expression of beta -catenin with a 10-year disease-free survival of 43.4%. By multivar iate analysis, low pathologic stage (stages I and II, p=0.001) and preserva tion of beta -catenin expression (p=0.012) were independently favorable pro gnostic factors. Our results indicate that changes in beta -catenin express ion occur during the progression of cervical adenocarcinoma to an invasive phenotype. These results suggest that beta -catenin is an important interce llular adhesion molecule. Assessment of beta -catenin immunoreactivity may be a useful prognostic tool in cervical adenocarcinoma complementary to est ablished prognostic factors. Furthermore, we developed a strategy for choos ing biomarkers representing the steps in malignant progression in an effort to identify patients with occult metastases who will need adjuvant therapy and spare women from unnecessary interventions.