TY - JOUR
T1 - Immunohistochemical and genetic profiles of endometrioid endometrial carcinoma arising from atrophic endometrium
AU - Geels, Yvette P.
AU - Van Der Putten, Louis J.M.
AU - Van Tilborg, Angela A.G.
AU - Lurkin, Irene
AU - Zwarthoff, Ellen C.
AU - Pijnenborg, Johanna M.A.
AU - Van Den Berg-Van Erp, Saskia H.
AU - Snijders, Marc P.L.M.
AU - Bulten, Johan
AU - Visscher, Daniel W.
AU - Dowdy, Sean C.
AU - Massuger, Leon F.A.G.
N1 - Publisher Copyright:
© 2015 Elsevier Inc.
PY - 2015
Y1 - 2015
N2 - Objective. Endometrial carcinomas are divided into type I endometrioid endometrial carcinomas (EECs), thought to arise fromhyperplastic endometrium, and type II nonendometrioid endometrial carcinomas, thought to arise fromatrophic 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-cadherinwas 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.
AB - Objective. Endometrial carcinomas are divided into type I endometrioid endometrial carcinomas (EECs), thought to arise fromhyperplastic endometrium, and type II nonendometrioid endometrial carcinomas, thought to arise fromatrophic 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-cadherinwas 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.
KW - Background endometrium
KW - Endometrial carcinoma
KW - Endometrioid
KW - Genetical
KW - Immunohistochemistry
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U2 - 10.1016/j.ygyno.2015.03.007
DO - 10.1016/j.ygyno.2015.03.007
M3 - Article
C2 - 25773202
AN - SCOPUS:84933278274
SN - 0090-8258
VL - 137
SP - 245
EP - 251
JO - Gynecologic oncology
JF - Gynecologic oncology
IS - 2
ER -