The re-awakening of hCG expression. Its role in the diagnosis of cervical squamous cell carcinoma

Abstract

Objectives: To compare immunohistochemical detection of Human chorionic gonadotropin (hCG) expression in paraffin embedded tissue of squamous cell carcinomas (SCC) and high grade squamous intraepithelial lesions (HSIL).

Methods: The samples in this retrospective study were obtained from the archives of the Pathology Department at Gaziantep University, Gaziantep, Turkey, over the period from January 2012 to September 2016. The study group consisted of 55 cases of SCC and 45 cases of HSIL. Tissue expression of hCG was detected by specific binding of anti-hCG antibody using an automated immunohistochemistry staining device. The categorical variables of intensity and coverage were analyzed statistically using Pearson Chi-Square test.

Results: High grade squamous cell lesions cases showed weak (84.4%, n=38/45) to no (15.6%, n=7/45) staining for hCG. None of the HSIL cases showed strong positivity. Strong positivity for hCG was detected in 90.9% (n=50/55) of SCC cases.

Conclusion: Our study supports the association of ectopic hCG expression in cancer pathogenesis by demonstrating strong hCG immunoreactivity only in SCC cases. This finding can be helpful in supporting the diagnosis of invasive carcinoma in small or fragmented biopsies, which can on their own be confusing for the pathologists.

Figure 1

IIllustration of immunohistochemical staining for hCG, demonstrating strong expression is related to squamous cell carcinoma (SCC). Panel a) weak immunohistochemical staining in high grade squamous intraepithelial lesions (HSIL) for human chorionic gonadotropin (hCG) (x100 photomicrograph); Panel b) weak immunohistochemical staining for hCG expression in high grade squamous intraepithelial lesions HSIL and adjacent NSE (x100 photomicrograph); Panel c) strong immunohistochemical staining for hCG expression in SCC, prominent at the periphery of the tumor (x40 photomicrograph); Panel d) strong, score 1 (1-10% of tumor cells) immunohistochemical staining for hCG expression (x100 photomicrograph); Panel e) strong, score 2 (50% of tumor cells) immunohistochemical staining for hCG expression (x200 photomicrograph); Panel f) strong, score 3 (≥50% of tumor cells) immunohistochemical staining for hCG (x200 photomicrograph).