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Immunohistochemical study of endometrial high‐grade endometrioid carcinoma with or without a concurrent low‐grade component: implications for pathogenetic and survival differences
Author(s) -
Mao TsuiLien,
Ayhan Ayse,
Kuo KuangTing,
Lin MingChieh,
Tseng LiHui,
Ogawa Hiroshi
Publication year - 2015
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.12664
Subject(s) - pten , microsatellite instability , immunohistochemistry , carcinoma , cancer research , pathogenesis , phenotype , pathology , biology , medicine , signal transduction , microsatellite , pi3k/akt/mtor pathway , gene , biochemistry , allele
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 ARID 1A, 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 ARID 1A 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 ARID 1A; P > 0.1 for other proteins). Pure HG tumours had a higher frequency of the type II phenotype (positive for ARID 1A, 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.