Predictors of outcome in small cell carcinoma of the cervix - A case series

Objective. The objective of this study was to determine whether clinicopath ologic findings or the immunohistochemical presence of molecular markers ar e predictive of clinical outcome in patients with small cell carcinoma of t he cervix (SCCC). Methods. A retrospective review of cases of carcinoma of the cervix was con ducted to identify SCCC. From 1978 to 1999, 16 patients were identified at our institution with the diagnosis of SCCC. Microscopic sections of paraffi n-embedded tissue specimens were evaluated for confirmation of diagnosis. S pecimens were immunohistochemically stained with antibodies to three neuroe ndocrine markers: neuron-specific enolase, chromagranin (CGR), and synaptop hysin. Specimens were also stained for protein expression of p53, erbB2, pr oliferating cell nuclear antigen, and c-myc. The relationship between molec ular markers and clinical outcome was determined. Results, All 16 cases met the histologic criteria for SCCC. Fourteen of 16 tumors (88%) stained positive for neuroendocrine differentiation. Eleven of 16 patients (69%) died from disease with a median survival of 19 months; t here were 3 long-term survivors (greater than 5 years). CGR was positive in 8 (50%) specimens and was found to be highly predictive of death (P = 0.00 1). Complete loss of p53 protein was seen in 8 patients, 7 of whom died wit h a median survival of 20 months. Conclusion. Immunohistochemistry can be helpful in confirming difficult cas es of SCCC. Further studies are necessary to define molecular markers that may be predictive of outcome in patients with SCCC. (C) 2001 Academic Press .