scholarly journals Molecular-based classification algorithm for endometrial carcinoma categorizes ovarian endometrioid carcinoma into prognostically significant groups

2017 ◽  
Vol 30 (12) ◽  
pp. 1748-1759 ◽  
Author(s):  
Carlos Parra-Herran ◽  
Jordan Lerner-Ellis ◽  
Bin Xu ◽  
Sam Khalouei ◽  
Dina Bassiouny ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Classification Algorithm ◽  
Endometrioid Carcinoma

scholarly journals p53, estrogen and progesterone receptors in diagnostic curettage for endometrial adenocarcinoma and their correlation with morphological data and disease stage at hysterectomy

2003 ◽  
Vol 121 (4) ◽  
pp. 163-166 ◽  
Author(s):  
Vera Lúcia Leite Bonfitto ◽  
Liliana Aparecida Lucci de Angelo Andrade
Keyword(s):  
Endometrial Carcinoma ◽  
Histological Grade ◽  
Endometrial Adenocarcinoma ◽  
Progesterone Receptors ◽  
Histological Type ◽  
Morphological Data ◽  
Disease Stage ◽  
Biological Behavior ◽  
Endometrioid Carcinoma ◽  
Estrogen And Progesterone Receptors

CONTEXT: Diagnostic staging is an important prognostic factor for endometrial adenocarcinoma. Apart from the histological type and histological grade, some markers seem to be associated with the stage and biological behavior of the disease. Among these are p53, estrogen and progesterone receptors. OBJECTIVE: The objectives of the present study were: to compare histological type and grading of endometrial carcinoma in curettage and hysterectomy samples; to assess expression of p53, estrogen and progesterone receptors in curettage specimens; and to correlate these data with morphology and staging of the disease in hysterectomy specimens. TYPE OF STUDY: Retrospective. SETTING: Department of Pathology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas. SAMPLE: Histological diagnosis from 51 consecutive files. PROCEDURES: Immunohistochemical reactions for p53, estrogen and progesterone receptors via the avidin-biotin-peroxidase method in 51 curettage samples endometrial carcinoma were compared with the morphological data and disease stage in hysterectomy. Marker expression was correlated with histological type and grade and the final stage of the disease. RESULTS: According to the histological type: 44 cases (86%) were of endometrioid and 7 (14%) non-endometrioid carcinoma. p53 expression was observed in 16% of endometrioid and 71% of non-endometrioid cases (p < 0.05). Although estrogen expression was more evident in endometrioid (54%) than non-endometrioid cases (29%), this was not statistically significant. Progesterone receptor expression was significantly higher in endometrioid than non-endometrioid cases (70% vs. 14%, p < 0.05). According to the histological grade: Estrogen and progesterone receptors were expressed more frequently in grade I endometrioid carcinoma, while p53 was mainly reported in tumor grades II and III. According to final disease stage: p53 and estrogen expression in curettage specimens was not related to stage; progesterone receptors, however, were expressed significantly less in advanced disease. CONCLUSION: p53 was observed in the majority of non-endometrioid and in high-grade endometrioid carcinoma, but was not related to stage. Estrogen and progesterone receptors were mainly found in grade I endometrioid carcinoma. The markers studied in curettage were no more valuable for predicting the disease stage than classical histological criteria.

A case of endometrial carcinoma in a long-term Levonorgestrel Intrauterine System (LNG 52 mg-IUS) user

2017 ◽  
Vol 23 (1) ◽  
pp. 13-14 ◽  
Author(s):  
Melisa Thomas ◽  
Paula Briggs
Keyword(s):  
Endometrial Carcinoma ◽  
Vaginal Bleeding ◽  
Endometrioid Carcinoma ◽  
Stage 1

This report describes a 50-year-old woman who presented to a community gynaecology clinic complaining of persistent heavy vaginal bleeding with an LNG 52 mg-IUS in situ. She was subsequently found to have stage 1 grade 1a endometrioid carcinoma. From the literature, we have identified five similar cases. This case highlights the possibility of endometrial carcinoma despite treatment with an LNG 52 mg-IUS and reinforces the importance of investigating women who present with unusual persistent or heavy vaginal bleeding.

Predictors of Survival After Recurrence in Women With Early-Stage Endometrial Carcinoma

2016 ◽  
Vol 26 (6) ◽  
pp. 1137-1142 ◽  
Author(s):  
Yiqing Xu ◽  
Charlotte Burmeister ◽  
Rabbie K. Hanna ◽  
Adnan Munkarah ◽  
Mohamed A. Elshaikh
Keyword(s):  
Endometrial Carcinoma ◽  
Cox Regression ◽  
Radiation Treatment ◽  
Early Stage ◽  
Pelvic Recurrence ◽  
Study Cohort ◽  
Adjuvant Radiation ◽  
Endometrioid Carcinoma ◽  
Entire Study ◽  
Cox Regression Analysis

ObjectiveFactors predictive of survival after recurrent early-stage endometrial carcinoma have not been thoroughly investigated. The purpose of this study was to explore factors that impact disease-specific survival (DSS) and overall survival (OS) after recurrence in women with early-stage endometrial carcinoma.Materials and MethodsAfter institutional review board approval, we identified 104 women with 2009 International Federation of Gynecology and Obstetrics stage I to II uterine endometrioid carcinoma who developed disease recurrence between January 1990 and December 2014. The Kaplan-Meier approach and Cox regression analysis were used to assess DSS and OS after recurrence and to determine factors influencing these survival end points.ResultsMedian age of the study cohort was 65 years with a median follow-up time of 42.8 months after hysterectomy. Median time to recurrence was 15.8 months. Recurrences were diagnosed in 60 patients (57.7%) who were originally managed with observation after hysterectomy and in 44 patients (42.3%) who were initially managed with adjuvant radiation treatment. Fifty-six patients (54%) had pelvic recurrence (vaginal and/or pelvic), whereas 48 (46%) had extrapelvic recurrence. Five-year DSS and OS for the entire study population was 44% and 37%, respectively. Five-year DSS and OS were longer for patients with pelvic recurrence compared with patients with extrapelvic recurrence (66% vs 18% and 55% vs 17%, P < 0.0001). Five-year DSS was also longer for radiation-naive patients than for radiation-treated patients (51% vs 34%, P = 0.023). On multivariate analysis of DSS and OS, pelvic recurrence (P < 0.001) was the only significant predictor of longer DSS and OS.ConclusionsIn women with recurrent early-stage endometrioid carcinoma, our study suggests that site of recurrence (pelvic vs extra pelvic) is the only predictor of survival. In addition, we found that radiation naivete and pelvic recurrence correlated with longer DSS and OS.

Molecular-based classification algorithm for endometrial carcinoma to categorize ovarian endometrioid carcinoma into prognostically significant groups.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17081-e17081
Author(s):  
Carlos Parra-Herran ◽  
Jordan Lerner-Ellis ◽  
Bin Xu ◽  
Dina Bassiouny ◽  
Matthew Cesari ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Mutational Analysis ◽  
Survival Rates ◽  
The Cancer Genome Atlas ◽  
Molecular Profile ◽  
Endometrioid Carcinoma ◽  
Wild Type ◽  
Molecular Subgroup ◽  
P53 Expression ◽  
Excellent Outcome

e17081 Background: The Cancer Genome Atlas classification divides endometrial carcinoma in biologically distinct groups, and testing for p53, mismatch repair proteins (MMR) and polymerase ɛ (POLE) exonuclease domain mutations has been shown to predict the molecular subgroup and clinical outcome. While abnormalities in these markers have been described in ovarian endometrioid carcinoma (OEC), their role in predicting its molecular profile and prognosis is still not fully explored. Methods: OECs resected in a 14 year period were retrieved. Only tumors with confirmed endometrioid histology and negative WT1 were included. POLE mutational analysis and immunohistochemistry for p53, MLH1, MSH2, MSH6 and PMS2 was performed in formalin-fixed, paraffin-embedded tissue. Following the molecular classifier proposed for endometrial carcinoma ( B J Cancer 2015;113:299-310), cases were classified as: POLE mutated, MMR abnormal, p53 abnormal and p53 wild type. Clinicopathologic information was recorded including patient outcome. Results: 73 tumors were successfully reviewed and tested. Of these, 8 (11%) were POLE mutated, 6 (8%) were MMR abnormal and 17 (23%) were p53 abnormal; the remaining 42 cases (58%) were p53 wild type (no POLE, p53 or MMR abnormalities). Mean follow-up period was 69 months (median 62, range 1-179). The molecular classification was an independent predictor for disease free and overall survival on multivariate analysis (p = 0.005 and 0.045 respectively, Cox proportional hazard model). POLE mutated and MMR abnormal groups had 100% 5 year DFS and OS. p53 wild type cases had intermediate survival rates (86% DFS and OS). Conversely, the p53 abnormal group had worse outcomes with 42% DFS and 76% OS at 5 years. Conclusions: OEC can be classified into prognostically distinct subgroups by testing for molecular surrogates, akin to endometrial cancer. MMR and POLE alterations seem to identify a subset of ovarian endometrioid carcinomas with excellent outcome; conversely, abnormal p53 expression carries a worse prognosis. In the era of personalized medicine, the use of these markers in the routine evaluation of ovarian endometrioid tumors should be considered.

Analysis of Prediagnostic Metabolic Profiles of Endometrial Carcinoma Patients in the Obese Population

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S13-S14
Author(s):  
X I Zhang ◽  
Amy Fox ◽  
Kathleen Whitney
Keyword(s):  
Endometrial Carcinoma ◽  
Cancer Diagnosis ◽  
Serous Carcinoma ◽  
Morbidly Obese ◽  
Metabolic Profiles ◽  
Endometrioid Carcinoma ◽  
Obese Population ◽  
Hba1c Levels

Abstract Endometrial carcinoma has been traditionally divided into type 1 and type 2 carcinomas. Excess estrogen is believed to be the pathologic mechanism of type 1 carcinoma. The WHO Classification of Tumors of Female Reproductive Organs lists obesity as a risk factor for type 1 endometrial carcinoma. On the contrary, type 2 carcinoma is generally not associated with estrogen or obesity. Endometrial endometrioid carcinoma is the most common type 1 carcinoma. Endometrial serous carcinoma is a typical type 2 carcinoma. In our community, with a high prevalence of obesity, we investigated whether serous carcinoma, a type 2 carcinoma, could also occur in the obese population, and whether there are identifiable metabolic differences between endometrioid carcinoma patients and serous carcinoma patients in the obese population prior to cancer diagnosis, which might provide clues to the different pathogenesis of the two types of carcinoma. Two cohorts of postmenopausal patients with serous carcinoma or endometrioid carcinoma between 2006 and 2016 were established. Then each cohort was subdivided into four categories based on patients’ average BMI (within 5 years before cancer diagnosis): nonobese (<30), moderately obese (30-35), severely obese (35-40), and morbidly obese (>40). Patients’ average triglycerides, HDL, blood pressures, and HbA1c levels (within 5 years before cancer diagnosis) were obtained. In total, 304 patients were in the endometrioid carcinoma cohort, while 135 patients were in the serous carcinoma cohort. In the morbidly obese category (BMI >40), serous carcinoma patients had significantly lower triglycerides and HbA1c levels than endometrioid carcinoma patients while their BMIs were comparable. For HDL and systolic and diastolic blood pressures, no significant difference was observed between the two groups. In each of the other BMI categories, serous carcinoma patients also had lower triglycerides and HbA1c levels than endometrioid carcinoma patients. In the serous carcinoma patient cohort, there was a moderately negative correlation between average BMI and triglycerides/HbA1c levels, with a Pearson’s correlation coefficient of –0.25 for triglycerides level and –0.19 for HbA1c level. On the contrary, there was no correlation between average BMI and triglycerides/HbA1c levels in the endometrioid carcinoma patient cohort (Pearson’s coefficient close to 0). In summary, the serous carcinoma patients in the obese population lacked the metabolic profiles generally associated with high BMI. These findings show that there are identifiable prediagnostic metabolic differences between endometrioid carcinoma patients and serous carcinoma patients. The metabolic differences between the two groups in each BMI category suggest that BMI should be combined with metabolic markers, rather than used alone, in the evaluation of risk factors for endometrial carcinoma. Future epidemiologic and experimental studies focusing on the association between metabolic syndrome and endometrial carcinoma should separate different histologic subtypes of endometrial carcinoma in the study design due to their distinct metabolic profiles.

scholarly journals Immunohistochemical Expression of “HE4” in Endometrial Hyperplasia versus Endometrial Endometrioid Carcinoma

2021 ◽  
Vol 9 (A) ◽  
pp. 669-675
Author(s):  
Amany Talaat Abd El-Hamed ◽  
Samira Abd-Allah Mahmoud ◽  
Ahmed A. Soliman ◽  
Dina F. El-Yasergy
Keyword(s):  
Endometrial Carcinoma ◽  
Endometrial Hyperplasia ◽  
Prognostic Significance ◽  
Atypical Hyperplasia ◽  
Cancer Tissue ◽  
Endometrioid Carcinoma ◽  
Immunohistochemical Expression ◽  
Atypical Endometrial Hyperplasia ◽  
Strong Expression

Aim Endometrial cancer is the most common cancer of the female genital tract. No effective biomarkers currently exist to allow for an efficient risk classification of endometrial carcinoma. Human epididymis protein 4 (HE4) overexpression is first observed in ovarian cancer tissue and subsequent research has shown that the HE4 overexpression has also been observed in patients with endometrial carcinoma. To our knowledge, this marker was evaluated in small number of research studies in cases of endometrial carcinoma versus hyperplasia. This has inspired us to test for immunohistochemical expression of HE4 in endometrial endometrioid carcinoma and hyperplastic endometria and to correlate HE4 expression with various prognostic pathological parameters including International Federation of Gynecology and Obstetrics (FIGO) grading and staging. Methods Immunohistochemical staining for HE4 was performed on paraffin-embedded sections of forty cases of endometrial endometrioid carcinoma and thirty cases of endometrial hyperplasia: including 15 cases of non-atypical hyperplasia and 15 cases of atypical hyperplasia. A histochemical score was used to evaluate HE4 expression by the tumor cells. Results In this study, HE4 overexpression level was significantly higher in endometrial endometrioid carcinoma than endometrial hyperplasia and significantly higher than non-atypical endometrial hyperplasia (P<0.05). HE4 strong expression was detected in 20% of atypical endometrial hyperplasia, but no statistical significance was detected between atypical hyperplasia and endometrial carcinoma. HE4 overexpression showed statistically significant positive correlation with FIGO grading, FIGO staging, and depth of myometrial invasion. Conclusion: During interpretation of endometrial biopsies of atypical hyperplasia, HE4 strong expression might raise the possibility of the presence of coexisting adenocarcinoma not biopsied or even warning of a near future malignant transformation. Also, strong expression of HE4 by tissue biopsy of adenocarcinoma should be reported as this might predict higher grade and stage of the tumor, a point that should be considered by surgeons while performing hysterectomy. These results should be further confirmed by extending the study on a large scale, correlation of HE4 expression with the molecular classification of Tumor Cancer Genome Atlas and long term follow up are required to establish the prognostic significance of HE4 expression in endometrial carcinoma and atypical hyperplasia. Keywords: Endometrial carcinoma, Endometrial hyperplasia, HE4, Immunohistochemistry.

Expression of p27 and p53: comparative analysis of uterine carcinosarcoma and endometrial carcinoma

2004 ◽  
Vol 14 (2) ◽  
pp. 354-359 ◽  
Author(s):  
A. Abargel ◽  
I. Avinoach ◽  
V. Kravtsov ◽  
M. Boaz ◽  
M. Glezerman ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Immunohistochemical Staining ◽  
Endometrioid Carcinoma ◽  
Uterine Carcinosarcoma ◽  
Clinical Value ◽  
P53 Overexpression ◽  
P53 Expression ◽  
Epithelial Component ◽  
Endometrial Carcinomas ◽  
Epithelial Element

The aim of the study was to assess both p27 and p53 expression in the stromal and epithelial component of carcinosarcoma and to assess if their expression in the latter is different than in endometrial carcinoma. Immunohistochemical staining for p27 and p53 was performed on paraffin-embedded tissue blocks of 18 uterine specimens with carcinosarcoma and their expression assessed. Their expression in the epithelial element was also compared to that in 35 paraffin-embedded tissue blocks of endometrial endometrioid carcinoma.Reduced p27 expression was observed in a similarly high proportion of the stromal (77.8%) as well as of the epithelial component (66.7%) of carcinosarcoma. Although statistically not significant, the proportion of reduced p27 expression in endometrial carcinoma (85.7%) was higher than in the epithelial element of carcinosarcoma.The percentage of p53 overexpression in both elements of carcinosarcomas and in endometrial carcinomas was low and also similar (27.8 and 20.0%, respectively).Our results indicate that reduced p27 expression is common and p53 overexpression is infrequent in carcinosarcoma. Their similar rates of expression in the stromal and epithelial elements of the tumor support the contention of a monoclonal origin of carcinosarcoma. Unexpectedly, reduced p27 expression is more common in endometrial carcinoma than in the epithelial element of carcinosarcoma, in spite of the less favorable prognosticators and outcome in the latter.Further studies of p27 expression in carcinosarcoma are indicated to establish its clinical value in this aggressive malignancy.

Mucinous Endometrial Carcinoma in a Patient with Previous Ovarian Endometrioid Adenocarcinoma Presenting Some 18 Years after Initial Bilateral Ovariectomy: A Case Report

1991 ◽  
Vol 36 (6) ◽  
pp. 181-182 ◽  
Author(s):  
G. J. Beattie ◽  
J. R. B. Livingstone ◽  
M. A. Cornbleet ◽  
J. F. Smyth ◽  
K. M. McLaren
Keyword(s):  
Case Report ◽  
Endometrial Carcinoma ◽  
Primary Carcinoma ◽  
Endometrioid Adenocarcinoma ◽  
Endometrioid Carcinoma ◽  
Uterine Tumour ◽  
Bilateral Ovariectomy ◽  
Carcinoma Of The Ovary

The association of endometrioid carcinoma of the ovary and primary carcinoma of the endometrium is well recognised. These tumours are often synchronous in occurrence. Oestrogen stimulation is often postulated as a significant factor in the development of the endometrial carcinoma in such cases. We describe the case of a patient who developed a mucinous endometrial carcinoma 18 years after initial bilateral ovariectomy. The aetiology and pathogenesis of the uterine tumour is discussed.

Endometrial carcinoma in the Baby Boomer generation: Tumor characteristics and clinical outcome.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15512-e15512
Author(s):  
Mohamed A. Elshaikh ◽  
Mira Shah ◽  
Richard Cattaneo II ◽  
Meredith Mahan ◽  
Thomas E. Buekers
Keyword(s):  
Endometrial Carcinoma ◽  
Baby Boomers ◽  
Local Control ◽  
Tumor Grade ◽  
Figo Stage ◽  
Study Cohort ◽  
Tumor Characteristics ◽  
Endometrioid Carcinoma ◽  
Disease Specific Survival ◽  
Disease Specific

e15512 Background: Baby Boomers (BB) enterring retirement are representing a significant burden on medical resources. The unique lifestyle characteristics engendered by the BB may lead to different endometrial cancer characteristics that bear understanding. We sought to characterize surgically staged BB patients with endometrioid carcinoma and compare the results to pre-Boomers (PB) patients. Methods: After reviewing our database of 1,450 patients with endometrial cancer, we identified 595 patients with 2009 FIGO stage I-II uterine endometrioid carcinoma who were born between 1926 and 1964. Their medical records were reviewed in this IRB-approved study. Patients with non-endometrioid carcinoma and those received preoperative therapy or chemotherapy were excluded. Patients were defined as BB (born 1946-1964) or PB (born in 1926-1945). The two groups were compared regarding patient’s demographics, tumor characteristics and survival. Results: All patients were surgically staged with a minimum of two years follow-up.BB group included 234 patients (39%) and PB with 361 patients (61%).Median follow-up for the study cohort was 72 months. Baby boomers had higher BMI (p=0.027), younger age at diagnosis (p=0.002), lower tumor grade (p=0.002), earlier FIGO stage (p=0.023), higher number of lymph dissected (p=0.008), less lymphovascular space involvement (LVSI) (p=<0.034), and less frequent utilization of adjuvant therapy (p=<0.001). However, there was no statistically significant difference found between the BB and PB in regards to local control, disease-specific survival and overall survival. For the study cohort, FIGO stage and tumor grade were independent predictors of local control and disease-specific survival. As to be expected, there was a trend towards shorter overall survival for the PB patients (p=0.063). Conclusions: Athough tumor characteristics were more favorable in the baby boomers generation, local control and survival endpoints were not statistically different compared to pre boomers. As more baby boomers are diagnosed with endometrial carcinoma, further research is warranted to further elucidate the characteristic differences of endometrial carcinoma, if any, in this generation.

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