Hep Par 1 expression in carcinoma of the cervix: implications for diagnosis and prognosis

Aims: To determine the frequency and pattern of Hep Par 1 expression in cervical carcinomas of various histological types and to correlate expression with prognostic parameters. Methods: Twenty nine cervical carcinomas were analysed for tumour type, hepatoid and neuroendocrine differentiation, and vascular invasion. A semiquantitative analysis was performed for Hep Par 1, α fetoprotein, chromogranin, and synaptophysin immunoreactivity. Results: Hep Par 1 expression was seen in seven of the 29 cervical carcinomas (three of seven adenocarcinomas, one of 17 squamous cell carcinomas, one of two adenocarcinomas with adenocarcinoma in situ, one of two adenocarcinomas in situ, and one of one large cell neuroendocrine carcinoma with adenocarcinoma in situ). Normal looking endocervical epithelium was also positive in one case. Cases expressing Hep Par 1, with or without neuroendocrine coexpression, were associated with a higher rate of vascular invasion and a worse prognosis. Three of the five cases expressing neuroendocrine markers also coexpressed Hep Par 1. Conclusions: Hep Par 1 expression in carcinoma of the cervix is not uncommon and is present in a variety of histological types. Expression of this marker appears to be associated with more aggressive biological behaviour and a worse prognosis. The uterine cervix is another site that may express Hep Par 1 and hence the use of this antibody in situations of diagnostic difficulty, especially involving lesions within the liver, have to be coupled with the knowledge of the range of tissues it may stain.