β-catenin expression as a prognostic indicator in cervical adenocarcinoma

The purpose of this study was to assess the prognostic influence of β-catenin expression by immunohistochemistry in patients with cervical adenocarcinomas. The study group comprised of 51 patients who underwent total hysterectomy for cervical cancer. The median follow-up was 39 months (range 1-138 months). β-catenin was expressed strongly on the membranes of normal cervical epithelial and glandular cells. Uniform membranous β-catenin staining localized to intercellular borders was observed in 35% of tumors, whereas 65% of tumors demonstrated an abnormal pattern of reduced or aberrant β-catenin expression (i.e., cytoplasmic and/or nuclear staining patterns). Abnormal β-catenin immunoreactivity was associated statistically with advanced pathologic stage (p=0.018). The 10-year disease-free survival was 51.0% in patients with preserved expression of β-catenin. On the other hand, a poorer prognosis was noted in the group with abnormal expression of β-catenin with a 10-year disease-free survival of 43.4%. By multivariate analysis, low pathologic stage (stages I and II, p=0.001) and preservation of β-catenin expression (p=0.012) were independently favorable prognostic factors. Our results indicate that changes in β-catenin expression occur during the progression of cervical adenocarcinoma to an invasive phenotype. These results suggest that β-catenin is an important intercellular adhesion molecule. Assessment of β-catenin immunoreactivity may be a useful prognostic tool in cervical adenocarcinoma complementary to established prognostic factors. Furthermore, we developed a strategy for choosing biomarkers representing the steps in malignant progression in an effort to identify patients with occult metastases who will need adjuvant therapy and spare women from unnecessary interventions.