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Immunohistochemical and genetic profiles of endometrioid endometrial carcinoma arising from atrophic endometrium.

AbstractOBJECTIVE:
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.
AuthorsYvette 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
JournalGynecologic oncology (Gynecol Oncol) Vol. 137 Issue 2 Pg. 245-51 (May 2015) ISSN: 1095-6859 [Electronic] United States
PMID25773202 (Publication Type: Journal Article)
CopyrightCopyright © 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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