Histopathologic features of advanced stage endometrial carcinoma

Objectives: Four to six percent of endometrial cancer (EC) cases have been diagnosed at an advanced stage. The aim of the study is to show the role of immunohistochemistry in the new endometrial carcinoma classification. Materials and Methods: Twenty-nine advanced Stage EC cases which were admitted to the Eskisehir Osmangazi Hospital were included in the study. One grade 1, 18 grade 2, and ten grade 3 EC cases were detected. Ten EC cases showed focal or diffuse strong p53 expression and three cases had Lynch syndrome with the dual loss of MLH1 and PMS2. In those cases that were above 60-years-old, PTEN inactivation, loss of PAX-8, and strong p16 positivity were detected. Five cases had focal or complete e-cadherin loss or inactivation and ten cases had focal CDX-2 expression and/or β cathenin nuclear expression due to β-cathenin mutation. Results: Nine out of 22 cases who had deep myometrial invasion showed MELF pattern of myometrial invasion (p = 0.05). Fallopian tube involvements were associated with mild p53 positivity (p = 0.002) and peritoneal washing fluid positivities were correlated with serosal involvement (p = 0.013). Three cases (10.3%) showed recurrences and one case died from the disease during the study. Conclusions: Tubal endometriosis or adenomyomatous polyp were found in the other tube in ECs with tubal involvement and these case had superficial myometrial invasion. Strong p53 expression and Lynch syndrome coexisted with the e-cadherin and β-cathenin mutations in advanced stage ECs.

Endometrial cancer; Immunohistochemistry; p53; MLH1; Advanced stage; Endometriosis

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