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

YP Geels, LJM van der Putten, AAG van Tilborg, Irene Lurkin, Ellen Zwarthoff, JMA Pijnenborg, SH van den Berg-va Erp, MPLM Snijders, J Bulten, DW Visscher, SC Dowdy, LFAG Massuger

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Objective. Endometrial carcinomas are divided into type I endometrioid endometrial carcinomas (EECs), thought to arise from hyperplastic endometrium, and type II nonendometrioid endometrial carcinomas, thought to arise from atrophic 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, beta-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-cadherin was 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. (C) 2015 Elsevier Inc. All rights reserved.
Original languageUndefined/Unknown
Pages (from-to)245-251
Number of pages7
JournalGynecologic Oncology
Issue number2
Publication statusPublished - 2015

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