Immunohistochemical study of endometrial high-grade endometrioid carcinoma with or without a concurrent low-grade component: Implications for pathogenetic and survival differences
Journal
Histopathology
Journal Volume
67
Journal Issue
4
Pages
474-482
Date Issued
2015
Author(s)
Abstract
Aims: To compare the clinical and pathogenetic differences between high-grade (HG) endometrioid carcinomas with and without concurrent low-grade (LG) components. Methods and results: The expression of ARID1A, PTEN, p53 and mismatch repair (MMR) proteins in HG endometrioid carcinomas without (n = 19) or with (n = 22) concurrent LG endometrioid carcinomas was studied by immunohistochemistry. Microsatellite instability (MSI) was also tested in 31 cases. The frequencies of ARID1A loss, PTEN loss, MMR deficiency or MSI and aberrant p53 expression were 58%, 37%, 37% and 47% in pure HG tumours, and 77%, 45%, 55% and 32% in HG tumours with concurrent LG components (P = 0.07 for ARID1A; P > 0.1 for other proteins). Pure HG tumours had a higher frequency of the type II phenotype (positive for ARID1A, PTEN and MMR proteins; aberrant p53 expression) than HG tumours with concurrent LG components (21% versus 5%) (P = 0.2). The 5-year overall survival rate was worse for pure HG tumours (61.7%) than for HG tumours with concurrent LG components (93.3%) (P = 0.07). Conclusions: HG endometrioid carcinomas are heterogeneous in pathogenesis: some arise from LG endometrioid carcinomas via the type I pathway, whereas others may arise de novo through either the type I pathway or the type II pathway, and have a different prognosis. Thus, HG endometrioid carcinomas should be subclassified properly and treated accordingly. ? 2015 John Wiley & Sons Ltd.
SDGs
Other Subjects
mismatch repair protein; phosphatidylinositol 3,4,5 trisphosphate 3 phosphatase; protein p53; retinoblastoma binding protein 2; tumor marker; adult; Article; cancer survival; carcinogenesis; clinical feature; controlled study; endometrioid carcinoma; female; gene frequency; human; human tissue; immunohistochemistry; microsatellite instability; middle aged; overall survival; phenotype; priority journal; protein expression; survival rate; endometrioid carcinoma; endometrium tumor; genetics; immunohistochemistry; Kaplan Meier method; mortality; pathology; Biomarkers, Tumor; Carcinoma, Endometrioid; Endometrial Neoplasms; Female; Humans; Immunohistochemistry; Kaplan-Meier Estimate; Microsatellite Instability; Middle Aged
Publisher
Blackwell Publishing Ltd
Type
journal article