Abstract | OBJECTIVE:
Endometrial carcinomas are divided into type I endometrioid endometrial carcinomas (EECs), thought to arise from hyperplastic endometrium, and type II nonendometrioid endometrial carcinomas, thought to arise from atrophic endometrium. However, a minority (20%) of EECs have atrophic background endometrium, which was shown to be a marker of a worse prognosis. This study compares the immunohistochemical and genetic profiles of this possible third type to that of the known two types. METHODS: 43 patients with grade 1 EEC and hyperplastic background endometrium (type I), 43 patients with grade 1 EEC and atrophic background endometrium (type III) and 21 patients with serous carcinoma (type II) were included (n=107). Tissue microarrays of tumor samples were immunohistochemically stained for PTEN, L1CAM, ER, PR, p53, MLH1, PMS2, β- catenin, E-cadherin and MIB1. The BRAF, KRAS, and PIK3CA genes were analyzed for mutations. RESULTS: A significantly higher expression of ER and PR, and a lower expression of L1CAM, p53 and MLH1 were found in type I and III compared to type II carcinomas. Expression of E-cadherin was significantly reduced in type III compared to type I carcinomas. Mutation analysis showed significantly less mutations of KRAS in type III compared to type I and II carcinomas (p<0.01). CONCLUSION: There appear to be slight immunohistochemical and genetic differences between EECs with hyperplastic and atrophic background endometrium. Carcinogenesis of EEC in atrophic endometrium seems to be characterized by loss of E-cadherin and a lack of KRAS mutations. As expected, endometrioid and serous carcinomas were immunohistochemically different.
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Authors | Yvette P Geels, Louis J M van der Putten, Angela A G van Tilborg, Irene Lurkin, Ellen C Zwarthoff, Johanna M A Pijnenborg, Saskia H van den Berg-van Erp, Marc P L M Snijders, Johan Bulten, Daniel W Visscher, Sean C Dowdy, Leon F A G Massuger |
Journal | Gynecologic oncology
(Gynecol Oncol)
Vol. 137
Issue 2
Pg. 245-51
(May 2015)
ISSN: 1095-6859 [Electronic] United States |
PMID | 25773202
(Publication Type: Journal Article)
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Copyright | Copyright © 2015 Elsevier Inc. All rights reserved. |
Topics |
- Atrophy
- Carcinoma, Endometrioid
(genetics, metabolism, pathology, surgery)
- Cohort Studies
- DNA Mutational Analysis
- Endometrial Hyperplasia
(pathology)
- Endometrial Neoplasms
(genetics, metabolism, pathology, surgery)
- Endometrium
(pathology)
- Female
- Humans
- Immunohistochemistry
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