Differential expression of MUC2 and MUC5AC in benign and malignant glandular lesions of the cervix uteri

Abstract

The expression of mucin genes in the normal glandular epithelium of the endocervix has been well characterized. However, mucin gene expression in neoplastic or particular non-neoplastic glandular cervical lesions has not been addressed. This immunohistochemical study was carried out to analyze the expression of MUC2 and MUC5AC in neoplastic and non-neoplastic glandular lesions of the cervix. Monoclonal antibodies were used on paraffin-embedded sections from 41 adenocarcinomas, 2 adenosquamous carcinomas, 13 adenocarcinomas in situ (ACIS), 3 glandular dysplasias, 8 endometrioses, 5 tubal metaplasias, 17 squamous metaplasias, 3 microglandular hyperplasias and normal tissue of the endocervix, endometrium and fallopian tube. The patterns of expression of MUC2 and MUC5AC were different and in principle contrary. Focal MUC2 expression was observed almost exclusively in neoplastic lesions (36%) and not in normal epithelia and non-neoplastic lesions, the one notable exception being immature metaplasia. In contrast, strong expression of MUC5AC was observed in both normal endocervical epithelium (100%) and neoplastic lesions (73%). The expression of MUC5AC, however, was diminished in most neoplastic glandular lesions. Co-expression of MUC2 and MUC5AC was consistently documented in the lesions with intestinal differentiation. In contrast, cases of tubal metaplasia and endometriosis were negative for MUC2 and MUC5AC. These results indicate that discrimination of mucin gene expression may be helpful in discriminating lesions of the cervix.

Eosinophilic cell change of the endometrium: a possible relationship to mucinous differentiation

“…According to those studies, endocervical mucinous epithelium has the same type of mucin as that of gastric foveolar epithelium. 10,11 Although the columnar epithelium of endometrial glands is characterized by the lack of cytoplasmic mucin, endocervical type mucinous epithelium can be seen in benign and neoplastic endometrium. 12,13 Primary mucinous adenocarcinoma of the endometrium 14 is considered to be the extreme of mucinous metaplasia in endometrioid adenocarcinoma and its clinical behavior does not differ significantly from that of conventional endometrioid adenocarcinoma.…”

Twelve Cases of Neuroendocrine Carcinomas of the Uterine Cervix: Cytology, Histopathology and Discussion of Their Histogenesis

“…It was limited to neoplastic conditions in a study of benign, premalignant and malignant endocervical glandular lesions [12]. Some markers such as HIK1083 and the intestinal mucin gene MUC2, which have been regarded as surrogate for intestinal metaplasia, were also limited in neoplastic conditions [13,14,15].…”

P16INK4A positivity in benign, premalignant and malignant cervical glandular lesions: a potential diagnostic problem

“…Indeed, a wide array of immunohistochemical markers has been evaluated with respect to their specificity in staining dysplastic cervical cells in biopsies and cytological smears. These include: MN, a transmembrane glycoprotein [19]; the proliferation marker, Ki-67/MIB1 [3,4,15,27]; bcl2 [3,23]; a cell-cycle protein, cyclin E [15]; the tumour suppressor protein, p53 [4]; CEA, carcinoembryonic antigen [4,21]; and mucin gene expression, MUC2 and MUC5AC [30]. However, the sensitivity and specificity of these markers are only of limited clinical utility and are only useful when used in a wide panel of markers.…”