Revista de citología e histología

Preoperative Cervical Cytology and E-Cadherin Expression in Endometrial Cancer

Abstract

Osogami H, Tanaka R, Suzuki T, Tamate M, Habata S, Sugio A, Matsuura M, Iwasaki M and Saito T

Objective: It is reported that cervical cytology is a significant factor related to stage, tumor grade, nodal metastasis, recurrence and survival rate in endometrial cancer. Moreover, reduced expression of the cell adhesion molecule E-cadherin is associated with higher tumor grade and metastasis in endometrial cancer. The objective of this study is to evaluate the relationship between the results of cytological assessment of glandular cells in cervical cytology before surgery, prognostic factors, and E-cadherin expression in endometrial cancer. Methods: Between 2004 and 2011, 263 patients with endometrial cancer at all stages were treated with hysterectomy. We reviewed preoperative cervical smears and assigned each to one of three categories: (1) Negative, (2) Atypical glandular cells (AGC), and (3) Adenocarcinoma (AC). The relationship of these cytology, prognostic factors, and E-cadherin expression was evaluated. Results: Statistical significance in overall survival was shown for preoperative cervical cytology, age, surgical stage, histological type, tumor grade, myometrial invasion, cervical involvement, lymph node metastasis except peritoneal cytology. Patients with AC cytology were more likely than those with normal cervical cytology to have a higher International Federation of Gynecology and Obstetrics (FIGO) stage, poorer histopathology, higher tumor grade, deeper myometrial invasion, higher incidence of cervical involvement, and higher prevalence of lymph node metastasis. In addition, AC and AGC cytology appeared to be associated with a poorer prognosis and to have lower E-cadherin expression than negative cytology. Conclusions: Cervical cytology may be a guide to prognosis in endometrial cancer, and E-cadherin expression may correlate with appearances of abnormal endometrial cells.