Immunohistochemical localizations of CA 125, carcinoembryonic antigen, and CA 19-9 in normal and neoplastic glandular cells of the uterine cervix.

Immunohistochemical reactivities with CA 125, carcinoembryonic antigen (CEA), and CA 19-9 were studied in 15 cervixes without histologic abnormalities, ten with microglandular hyperplasia, nine adenocarcinomas in situ, ten adenocarcinomas with an invasion of less than 5 mm in depth, and 25 frankly invasive adenocarcinomas of the uterine cervix. The glandular cells of the normal cervix and microglandular hyperplasia always exhibited reactivity with anti-CA 125 in the luminal surfaces and the secretory products within the lumina, but there was usually no reactivity with either anti-CEA or anti-CA 19-9. In the neoplastic glandular cells (adenocarcinoma in situ and invasive adenocarcinoma), the reactivity with anti-CA 125 was negative or was not in the luminal surface, but in the perinuclear region of the cytoplasm as accumulations of atypical coarse granules. In addition, the positive reaction with anti-CEA and anti-CA 19-9 was seen in 78% and 0% of adenocarcinomas in situ, in 80% and 40% of adenocarcinomas less than 5 mm in depth, and in 84% and 56% of frankly invasive adenocarcinomas, respectively. Therefore, neoplastic cervical glandular cells show an unusual staining pattern with anti-CA 125, which may be associated with impaired production and/or the intracytoplasmic transport of CA 125, and they begin to produce antigens recognized by anti-CEA and/or anti-CA 9-9, which are usually negative in the normal tissue.