Significance of mucin stains in the diagnosis of carcinoma of cervix
Keywords:
Carcinoma cervix, Mucin, PAS & Alcian BlueAbstract
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.1583
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Copyright (c) 2018 Linda Lamngaiching Changsan, Pranita Medhi, Utpal Dutta
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