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

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 Christopher Dowdy, Leon F A G Massuger

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)245-251
Number of pages7
JournalGynecologic Oncology
Issue number2
StatePublished - 2015


  • Background endometrium
  • Endometrial carcinoma
  • Endometrioid
  • Genetical
  • Immunohistochemistry

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

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