Document Type: Research Articles
Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, Malaysia.
Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Malaysia.
Department of Obstetrics and Gynecology, School of Medical Sciences, Universiti Sains Malaysia, Malaysia.
Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Malaysia.
Background: Cervical cancer is a preventable disease caused by human papillomaviruses. It is the third most
common cancer to occur in women of reproductive age. The ADAM9 protein plays a role in basement membrane
degradation and tumour metastasis in certain types of tumour. Thus, it has the potential to become a new targeted
therapy. The objective of this study was to investigate ADAM9 expression in cervical cancer and to determine the
factors associated with ADAM9-positive expression. Methods: This cross-sectional study was conducted in Hospital
Universiti Sains Malaysia (HUSM) Kelantan, Malaysia from December 2010 to December 2012. Histological slides
obtained from 95 cervical cancer cases diagnosed and/or treated in HUSM from 2000 to 2010 were analysed. The
ADAM9 immunostain was then performed on the paraffin blocks. The statistical data entry and analysis were done
using SPSS version 18.0. Multiple logistic regression analysis was performed to determine the factors associated with
ADAM9-positive expression. Result: Of the 95 cervical cancer patients included in the study, 72 (75.8%) patients showed
positive ADAM9 expression. The mean age of the patients was 53.89 (10.83) years old. Squamous cell carcinoma was
the most common type of cervical cancer (n = 67, 70.5%). Factors that showed a statistically significant association
with ADAM9-positive expression were tumour size (adjusted odds ratio [adj. OR]: 1.08; 95% confidence interval
[CI]: 1.02, 1.13; p = 0.004), distant metastasis (adj. OR: 12.82; 95% CI: 1.91, 86.13; p = 0.009) and the histological
type of cervical cancer (i.e. squamous cell carcinoma) (adj. OR: 7.39; 95% CI: 1.42, 38.51; p = 0.017). Conclusion:
The ADAM9 immunostain was consistently positive in malignant cells. Thus, ADAM9 expression can be used as a
prognostic/therapeutic indicator in aiding clinician decision-making regarding patient treatment (targeted therapy).