OBJECTIVETo evaluate the value of the detection of a 4-marker (ER, VIM, CEA and p16) panel in the differential diagnosis of primary endocervical and endometrial adenocarcinomas.

METHODSImmunohistochemical EnVison method was used to detect the expressions of ER, VIM, CEA and p16 in paraffin-embedded tissues from 31 cases of primary endocervical adenocarcinomas and 30 cases of endometrial adenocarcinomas. The specificity, sensitivity, predictive value and accuracy were compared between the 4-marker and 3-marker (ER, VIM and CEA) panels.

RESULTSThe positivity rates of ER, VIM, CEA and p16 in endocervical adenocarcinomas were 35.5%, 19.4%, 77.4% and 67.7%, respectively; those in endometrial adenocarcinomas were 70%, 73.3%, 40% and 13.3%, respectively, showing significant frequency differences (P<0.05) between primary endocervical and endometrial adenocarcinomas. The specificity, sensitivity, positive predictive value and accuracy of the 4-marker panel in endocervical adenocarcinomas were significantly higher than those of the 3-marker panel (96.3% vs 90.2%, 65.1% vs 57.6%, 94.9% vs 89.4%, and 85.8% vs 80.6%, respectively). These values were almost similar for both panels in endometrial carcinoma except for better negative predictive value and accuracy value with the 4-marker panel (58.7% vs 51.9% and 75.4% vs 68.6%, respectively).

CONCLUSIONAdding the p16 marker to the traditional 3-marker panel may have significant clinical importance in the differential diagnosis of primary endocervical and endometrial adenocarcinomas to improve the diagnostic accuracy, although there is only a slight increase in the diagnostic sensitivity.