Significance of mucin stains in the diagnosis of carcinoma of cervix
Keywords:
Carcinoma cervix, Mucin, PAS & Alcian Blue
Abstract
Background: As many as 25-35% of carcinoma cervix without clearly defined glandular structure on histopathological examination by Hematoxylin and Eosin stains have intracellular mucin demonstrable by using mucin stains which may redefine the classification of cervical carcinomas which becomes important as mucus secreting neoplasms resembling pure squamous cell carcinomas are more aggressive and have worse prognosis than their purely squamous counterparts.Methods: Our study conducted at Assam Medical College Dibrugarh for a period of one year. 54 cases of carcinoma cervix diagnosed on Hematoxylin and Eosin stain were subjected to mucin stains i.e. Periodic acid Schiff and Alcian blue at pH 2.5 and the results were compared with each other.Result: Out of the total 54 cases, 47 cases were squamous cell carcinoma(SCC,87.03%) which were further graded as well differentiated type(12/47)SCC, moderately differentiated(31/47)SCC, poorly differentiated(4/47)SCC and only 3 cases were adenosquamous carcinoma( 3/54; 5.5%) and adenocarcinoma( 4/54; 7.41%) by conventional H& E stain. On subjecting to specific mucin stains, however 21.2% (10 cases)of the SCC(47 cases) contained intracellular mucin with varying percentage, along with adenocarcinoma and adenosquamous carcinomas . Revised diagnosis after application of mucins stains showed pure squamous cell carcinomas (37/54) i.e. 68.51%, adenocarcinomas remained same at 7.41% (4/54) and adenosquamous carcinoma increased(13/54) to 24.07%.Conclusion: Identifying adenosquamous carcinomas after application of mucin stains which were not detectable by H&E stained sections has sparked academic interest because of its prognostic significance as it has been found in various studies that adenosquamous carcinomas often pursue an aggressive course and are associated with worse prognosis than their pure adeno- and squamous – counterparts as most of them are poorly differentiated. So recognition of this type of carcinomas can help to predict prognosis and to plan management.DOI:10.21276/APALM.1583References
(1) Ferlay J, Soerjomataram I, Ervik M, Dikshit R et al. Mortality Worldwide: IARC Cancer Base No. 11.Lyon, France: International Agency for Research on Cancer; 2013.
(2) Kent A. “HPV vaccination and Testing”. Reviews in obstetrics and gynecology. 2010; 3 (1): 33-34.
(3) Preeti , Kalhan S, Alka , Jain K et al. Should mucin histochemistry be Routinely done for carcinoma cervix. Journal of Clinical and Diagnostic Research 2010 August ; 4:2714-2719.
(4) Kurman RJ, Carcangiu ML, Herrington CS et al. WHO Classification of Tumours of Female Reproductive Organs. WHO/IARC Classification of Tumours, 4th Edition, Volume 6 IARC. Lyon 2014.
(5) Colgan TJ, Auger M, McLaughin JR. Histopathological classification of cervical carcinoma and recognition of mucin secreting squamous carcinoma. Int J Gynaecol Pathol 1993; 12:64-69.
(6) Arbyn M, Castellsague X, De Sanjose S et al. Worldwide burden of cervical cancer. Ann Oncol. 2011; 22: 2675–2686.
(7) V Misra, S C Gupta, A Goel et al. Re-classification of carcinoma cervix uteri by mucin histochemistry. Indian Journal of Pathology and Microbiology. 1997; 40 (4 ): 463.
(8) Mathur SK, Marwaha N, Arora et al. Significance of Mucin Secretion in Carcinoma of uterine cervix. India J. Pathol Microbiol. 2002; 45 (3): 261.
(9) Keshav P, Virendra K, Pratik C. Utility of PAS and Alcian Blue Stains in Carcinoma Cervix. International Journal of Biomedical Research 2016; 7 (8): 606.
(2) Kent A. “HPV vaccination and Testing”. Reviews in obstetrics and gynecology. 2010; 3 (1): 33-34.
(3) Preeti , Kalhan S, Alka , Jain K et al. Should mucin histochemistry be Routinely done for carcinoma cervix. Journal of Clinical and Diagnostic Research 2010 August ; 4:2714-2719.
(4) Kurman RJ, Carcangiu ML, Herrington CS et al. WHO Classification of Tumours of Female Reproductive Organs. WHO/IARC Classification of Tumours, 4th Edition, Volume 6 IARC. Lyon 2014.
(5) Colgan TJ, Auger M, McLaughin JR. Histopathological classification of cervical carcinoma and recognition of mucin secreting squamous carcinoma. Int J Gynaecol Pathol 1993; 12:64-69.
(6) Arbyn M, Castellsague X, De Sanjose S et al. Worldwide burden of cervical cancer. Ann Oncol. 2011; 22: 2675–2686.
(7) V Misra, S C Gupta, A Goel et al. Re-classification of carcinoma cervix uteri by mucin histochemistry. Indian Journal of Pathology and Microbiology. 1997; 40 (4 ): 463.
(8) Mathur SK, Marwaha N, Arora et al. Significance of Mucin Secretion in Carcinoma of uterine cervix. India J. Pathol Microbiol. 2002; 45 (3): 261.
(9) Keshav P, Virendra K, Pratik C. Utility of PAS and Alcian Blue Stains in Carcinoma Cervix. International Journal of Biomedical Research 2016; 7 (8): 606.
Published
2018-03-01
Issue
Section
Original Article
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
