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L1 cell adhesion molecule (L1CAM) in stage IB cervical cancer: distinct expression in squamous cell carcinomas and adenocarcinomas
  1. Joao Paulo Mancusi de Carvalho1,
  2. Rafael C Salim2,
  3. Filomena Marino Carvalho2,
  4. Maria Luiza Nogueira Dias Genta1,
  5. Edmund Chada Baracat1,
  6. Jesus Paula Carvalho1
  1. 1Gynecology, Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil
  2. 2Pathology, Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil
  1. Correspondence to Professor Filomena Marino Carvalho, Pathology, Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil; filomena{at}


Aims L1 cell adhesion molecule (L1CAM) has been shown to be correlated with tumour progression, attributed to its possible association with epithelial-mesenchymal transition (EMT), characterised by the expression of vimentin and loss of e-cadherin. Herein, we investigate the associations between L1CAM and clinicopathological parameters, as well as the expression of vimentin and e-cadherin, in carcinomas restricted to the cervix.

Methods The study was retrospective observational and included 45 squamous cell carcinomas (63.4%) and 26 adenocarcinomas (36.6%) submitted to primary surgical treatment. Patient age, FIGO (International Federation of Gynecology and Obstetrics) stage, tumour size and follow-up were obtained from the medical records. All the slides were revised to evaluate histological differentiation, lymphovascular space invasion, depth of infiltration, disease-free cervical wall thickness, pattern of invasion front, Silva pattern (for adenocarcinomas) and the percentage of tumour-infiltrating lymphocytes. Tissue microarrays were constructed for immunohistochemical staining for L1CAM, e-cadherin and vimentin.

Results Adenocarcinomas were associated with lower disease-free and overall survival. L1CAM and vimentin expressions were more frequent among adenocarcinomas, although loss of e-cadherin expression was more common among squamous carcinomas. L1CAM expression was associated with larger tumours, vimentin expression and lower disease-free survival. No association was observed between the expression of either L1CAM or vimentin and loss of e-cadherin. High levels of tumour-infiltrating lymphocytes were more frequent in squamous cell carcinoma, high-grade tumours, destructive pattern at front of invasion and loss of e-cadherin expression.

Conclusions Our results confirm the prognostic role of L1CAM in cervical carcinomas, but suggest a role for mechanisms other than EMT.

  • cervix uteri
  • uterine cervical neoplasms
  • immunohistochemistry
  • pathology, molecular
  • pathology, surgical

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  • Handling editor Mona El-Bahrawy.

  • Contributors JPMC: data curation, writing–original draft. RCS: methodology. FMC: conceptualisation, formal analysis, writing–review and editing. MLNDG: data curation, methodology. ECB: supervision. JPC: conceptualisation, writing, supervision. All authors have access to the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the Scientific Committee of Faculdade de Medicina da Universidade de Sao Paulo and by the Ethics Committee for Research Projects of the Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (Comissao de Etica para Analise de Pesquisa - CAPPesq) (1.294.094) and Plataforma Brasil (CAAE 03350012.2.0000.0065). The study complies with the ethical precepts proposed by the legislation in force in Brazil (R466/2012).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. All data relevant to the study are included in the article. More details about the patients are contained in the institution’s medical records and are protected by guaranteed anonymity.