Various clinical and histopathologic characteristics are currently used to obtain prognostic information about cervical carcinoma, but they do not predict accurately the outcome for any individual patients. Thus, there is a need to identify additional tumor characteristics that are able to predict more accurately the outcome for an individual patient with cervical cancer. In this study, we explored the relationship between cathepsin-D expression and progression of the cervical neoplasia, the correlation between response to neoadjuvant chemotherapy and cathepsin-D expression, and we investigated if tumor cell cathepsin-D expression could serve as a prognostic factor in cervical carcinoma. Tumor tissues were obtained from 14 patients with cervical intraepithelial neoplasia and 52 patients with squamous cell carcinoma of the cervix. Cathepsin-D expression was identified by immunohistochemical methods using monoclonal antibody cathepsin-D (BioGene). Positive cathepsin-D immunoreaction in greater than 30% of carcinoma cells was scored as high expression High cathepsin-D expression was seen in 15 of 52 invasive cervical cancer but was absent in cervical intraepithelial neoplasia. It was shown that cathepsin-D expression was independent of the tumor grade, tumor size, lymph node involvement, depth of invasion, parametrial invasion, and response to chemotherapy. In disease free survival analysis by log-rank test, cathepsin-D expression was not significantly associated with survival. These results show that cathepsin-D expression is not a clinically useful adjunct to assessment of prognosis in invasive squamous cell carcinoma of the cervix.
Carcinoma, Squamous Cell ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Disease-Free Survival ; Drug Therapy ; Female ; Humans ; Lymph Nodes ; Prognosis ; Uterine Cervical Neoplasms