The biologic behavior of squamous cervical carcinoma after neoadjuvant therapy (NAT) according to immunohistochemical expression of E-cadherin and CD44v6

Mihaela Madalina Gavrilescu, Raluca Balan, Viorel Scripcariu, Dan Ferariu, Ludmila Lozneanu, Diana Popovici, Cornelia Amalinei


The efficiency of neoadjuvant therapy in cervical carcinoma has been well demonstrated, although the cellular mechanisms of different response to this treatment have not been thoroughly investigated. The present study consists of 24 patients with cervical cancer, including 12 patients in stages IB-IIIB with first-line surgical treatment and 12 patients in stages IIB-IIIB, with neoadjuvant therapy followed by radical hysterectomy. The aim of our study was to assess the correlations between the alterations in E-cadherin and CD44v6 immunoexpression in cervical carcinoma, as a tool of evaluation the response to neoadjuvant therapy and its prognostic significance. The intensity of CD44v6 immunoexpression was higher in more aggressive tumors and E-cadherin immunoexpression was approximately constant among the cases with neoadjuvant therapy. Our results demonstrate that the evaluation of CD44v6 immunoexpression in cervical carcinomas is useful for the assessment of tumor response to neoadjuvant therapy and of tumor aggressiveness. The high level of E-cadherin immunoexpression in tumors with neoadjuvant therapy reflects its involvement in the prevention of HPV oncoproteins action, with benefits on the outcome. A larger group of patients and a panel of antibodies, including CD4 and COX2, could provide a better characterization of the tumor response to neoadjuvant therapy, with a positive prognosis impact.


E-cadherin, CD44v6, cervical carcinoma, neoadjuvant therapy

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Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010; 127:2893-2917.

Nagy VM, Buiga R, Brie I, et al. Expression of VEGF, VEGFR, EGFR, COX-2 and MVD in cervical carcinoma, in relation with the response to radio-chemotherapy. Rom J Morphol Embryol 2011; 52:53-59.

Costa S, Terzano P, Bovicelli A, et al. CD44 isoform 6 (CD44v6) is a prognostic indicator of the response to neoadjuvant chemotherapy in cervical carcinoma. Gynecol Oncol 2001; 80(1):67-73.

Biesold C, Kohler U, Horn LC, et al. CD 44 exon v6 as a predictor of lymphatic metastases in cervical carcinoma--an immunocytochemical study of 94 cases. Arch Gynecol Obstet 1995; 256(3):147-153.

Kainz C, Tempfer C, Kohlberger P, et al. Immunohistochemical detection of adhesion molecule CD44 splice variants in lymph node metastases of cervical cancer. Int J Cancer 1996; 69(3):170-173.

Speiser P, Wanner C, Tempfer C, et al. CD44 is an independent prognostic factor in early-stage cervical cancer. Int J Cancer 1997; 74(2):185-188.

Carico E, Atlante M, Bucci B, et al. E-cadherin and alpha-catenin expression during tumor progression of cervical carcinoma. Gynecol Oncol 2001; 80:156-161.

Cruz MCFN, Pereira ALA, Lopes FF, et al. Immunohistochemical Expression of E-cadherin and CD44v6 in Squamous Cell Carcinomas of the Lower Lip and Tongue. Braz Dent J 2009; 20(1):64-69.

Bouda J, Boudova L, Hes O, et al. CD44v6 as a prognostic factor in cervical carcinoma FIGO stage IB. Anticancer Res 2005; 25:617-622.

Vessey CJ, Wilding J, Folarin N, et al. Altered expression and function of E-cadherin in cervical intraepithelial neoplasia and invasive squamous cell carcinoma. J Pathol 1995; 176(2):151-159.

Thiery JP, Sleeman JP. Complex networks orchestrate epithelial-mesenchymal transitions. Nat Rev Mol Cell Biol 2006; 7:131-142.

Hirohashi S, Kanai Y. Cell adhesion system and human cancer morphogenesis. Cancer Sci 2003; 94:575-581.

Hellner K, Mar J, Fang F, et al. HPV16 E7 oncogene expression in normal human epithelial cells causes molecular changes indicative of an epithelial to mesenchymal transition. Virology 2009; 391(1):57-63.

Ancuta E, Ancuta C, Cozma LG etal. Tumor biomarkers in cervical cancer: focus on Ki-67 proliferation factor and E-cadherin expression. Rom J Morphol Embryol 2009; 50:413-418.

Cheng Y, Zhou Y, Jiang W et al. Significance of E-cadherin, beta-catenin, and vimentin expression as postoperative prognosis indicators in cervical squamous cell carcinoma. Hum Pathol 2012; 43:1213-1220.


Copyright (c) 2016 Mihaela Madalina Gavrilescu, Raluca Balan, Viorel Scripcariu, Dan Ferariu, Ludmila Lozneanu, Diana Popovici, Cornelia Amalinei

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