Predicting the Coexistence of an Endometrial Adenocarcinoma in the Presence of Atypical Complex Hyperplasia: Immunohistochemical Analysis of Endometrial Samples

2012 ◽  
Vol 22 (7) ◽  
pp. 1264-1272 ◽  
Author(s):  
Elisabeth J.M. Robbe ◽  
Sander M.J. van Kuijk ◽  
Ella M. de Boed ◽  
Luc J.M. Smits ◽  
Anneke A.M. van der Wurff ◽  
...  
Keyword(s):  
Prediction Model ◽  
Endometrial Carcinoma ◽  
Endometrial Hyperplasia ◽  
Endometrial Adenocarcinoma ◽  
Univariate Analysis ◽  
Area Under The Curve ◽  
Immunohistochemical Analysis ◽  
Pten Expression ◽  
Immunohistochemical Markers ◽  
Mib 1

ObjectiveThis study aimed to determine whether immunohistochemical markers in complex atypical endometrial hyperplasia could predict the presence of a concurrent endometrial carcinoma.MethodsEndometrial biopsies of 39 patients with complex atypical hyperplasia were selected retrospectively between 1999 and 2006. Only patients who underwent a hysterectomy were included. A coexisting endometrial carcinoma was present in 25 patients (64%). Immunohistochemical analysis was performed on formalin-fixed paraffin-embedded sections of the endometrial biopsies, using antibodies for MIB-1, β-catenin, E-cadherin, p53, PTEN, CD44, HER2-neu, survivin, COX-2, tenascin, and bcl-2. To evaluate the potential utility of these markers, a prediction model was constructed.ResultsIn the univariate analysis, expressions of both PTEN and HER2-neu were significantly different between the groups with and without a coexisting endometrial carcinoma (P < 0.05). Loss of PTEN staining was found in 13 (54%) and 1 (7%) of the patients with and without a coexistent carcinoma, respectively (odds ratio, 16.55; 95% confidence interval [CI], 1.87–146.65). HER2-neu expression was found in only 2 (8.6%) and 6 (43%) patients with and without a coexistent carcinoma, respectively, and was excluded from further analysis because of its low expression. A prediction model containing PTEN expression only showed an area under the curve of 73.4% (95% CI, 57.3%–89.6%). After adding MIB-1 and p53, discriminative power improved to 87.2% (95% CI, 75.1%–99.3%).ConclusionsThis study showed that PTEN expression in complex endometrial hyperplasia is a promising factor for the prediction of the presence of a coexisting endometrial carcinoma, and prediction may even better when MIB-1 and p53 expressions are considered simultaneously.

ATL

2014 ◽  
Vol 24 (3) ◽  
pp. 534-540 ◽  
Author(s):  
Zheng-mao Zhang ◽  
Shuang Xiao ◽  
Guang-yu Sun ◽  
Yue-ping Liu ◽  
Feng-hua Zhang ◽  
...  
Keyword(s):  
Estrogen Receptor ◽  
Endometrial Carcinoma ◽  
Endometrial Hyperplasia ◽  
Clear Cell ◽  
Clinical Stage ◽  
Endometrial Adenocarcinoma ◽  
Myometrial Invasion ◽  
Suppressor Gene ◽  
Differentiation Status ◽  
Endothelial Growth Factor

ObjectiveAT-rich interactive domain 1A (ARID1A) is a tumor suppressor gene that encodes the BAF250a protein. Recent studies have shown the loss ofARID1Aexpression in several types of tumors. We aimed to investigate the clinical and pathologic role of BAF250a in endometrial carcinoma.MethodsWe examined the expression of BAF250a and its correlation with the expression of p53, estrogen receptor, progesterone receptor, glucocorticoid receptor, hypoxiainduciblefactor-1α, and vascular endothelial growth factor in normal and various malignant endometrial tissues.ResultsThe expression of BAF250 was significantly down-regulated in endometrial carcinoma when compared with normal endometrial tissues. The loss of BAF250a expression was found in 25% of endometrial carcinoma samples but not in normal endometrial tissues, complex endometrial hyperplasia, and atypical endometrial hyperplasia samples. Subtypes of endometrial carcinoma, especially uterine endometrioid carcinoma and uterine clear cell carcinoma, had higher frequency of loss of BAF250a expression. In addition, the expression of BAF250a was positively correlated with estrogen receptor and negatively correlated with p53 in poorly differentiated endometrial adenocarcinoma. Moreover, the expression of BAF250a was significantly associated with the differentiation status of endometrial carcinoma but not associated with clinical stage, the depth of myometrial invasion, lymph node metastasis, and overall survival of patients with endometrial carcinoma.ConclusionsOur data showed that loss of BAF250a is frequently found in high-grade endometrioid and clear cell carcinomas but not in other types of endometrial carcinoma. The loss of BAF250a expression does not have prognostic value for endometrial carcinoma.

scholarly journals A study of PTEN expression in endometrial hyperplasia and endometrioid type of endometrial carcinoma

2017 ◽  
Vol 3 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Dr. Shanmugapriya M. ◽  
◽  
Dr. Sudha M. ◽  
Dr. Geetha Prakash ◽  
◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Endometrial Hyperplasia ◽  
Pten Expression

Endometrial Carcinoma under the Age of 40.

1975 ◽  
Vol 61 (5) ◽  
pp. 451-456 ◽  
Author(s):  
Francesco Faggiano ◽  
Mario Trabucco ◽  
Silvana Grasso ◽  
Marcello Filotico
Keyword(s):  
Endometrial Carcinoma ◽  
Endometrial Hyperplasia ◽  
Endometrial Adenocarcinoma ◽  
The Other ◽  
Histological Pattern ◽  
Atypical Endometrial Hyperplasia ◽  
Type 3 ◽  
Benign Course

Endometrial adenocarcinoma in women under the age of forty presents a different course according to its histology. Adenocarcinomas of the endometrium may be classified into 4 main types: type 1, homologous or endometrioid; type 2, fallopian-like; type 3, cervical-like; type 4, unclassifiable. The majority of homologous adenocarcinomas have a relatively benign course, whereas the other types are definitely malignant. There is no room for doubt between adenocarcinoma and atypical endometrial hyperplasia in women under forty unless the histological pattern is of the homologous or endometrioid type, because the other patterns are definitely malignant.

Histologic and Immunohistochemical Analyses of Endometrial Carcinomas: Experiences From Endometrial Biopsies in 358 Consultation Cases

2013 ◽  
Vol 137 (11) ◽  
pp. 1574-1583 ◽  
Author(s):  
Jian-Jun Wei ◽  
Ajit Paintal ◽  
Pacita Keh
Keyword(s):  
Endometrial Carcinoma ◽  
Endometrial Adenocarcinoma ◽  
Serous Carcinoma ◽  
Type I ◽  
Tumor Type ◽  
Type Ii ◽  
Endometrioid Carcinoma ◽  
Immunohistochemical Markers ◽  
Uterine Serous Carcinoma ◽  
Endometrial Carcinomas

Context.—Uterine serous carcinoma is biologically more aggressive than the endometrioid carcinoma. Because uterine serous carcinoma has a high propensity for lymphovascular invasion and intraperitoneal and extra-abdominal spread, accurate diagnosis of this tumor type in endometrial biopsies/curettings is critical for appropriate clinical management. Objective.—To share our experience in the evaluation of endometrial biopsy specimens in type I and type II endometrial adenocarcinoma. Design.—We retrospectively reviewed 358 biopsies containing endometrial carcinoma during a recent 3 year period of our consultation records. In cases in which our interpretation differed from the submitting diagnosis, a panel of immunostains was performed. The performance characteristics of each antibody in our panel was calculated in this group of challenging cases. Results.—Among the endometrial carcinomas we examined, a diagnosis of type I carcinoma accounted for 91% of cases (327 of 358) and type II carcinoma for 9% of cases (31 of 358); 41 cases (11.5%) were ambiguous or discordant (differing from submitted diagnoses and reviewed) based on histology alone. All 41 ambiguous and discordant cases were further evaluated with a battery of immunohistochemical markers. Of the 41 cases, 36 (88%) were ultimately classified (10 cases [24%] were endometrioid carcinoma; 18 cases [44%] were uterine serous carcinoma; 8 cases [20%] resulted in various other outcomes) and 5 cases (12%) remained indeterminate. Conclusions.—Making the distinction between type I and II endometrial carcinoma remains a common problem in general practice. Although no one biomarker provides excellent statistical performance, a panel of immunohistochemical markers is often useful in difficult cases.

scholarly journals Unusual Presentation of Recurrent Early Stage Endometrial Carcinoma 28 Years after Primary Surgery

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Alessandro Franchello ◽  
Gianruggero Fronda ◽  
Giacomo Deiro ◽  
Alessia Fiore ◽  
Davide Cassine ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Early Stage ◽  
Rectal Wall ◽  
Endometrial Adenocarcinoma ◽  
Neoadjuvant Treatment ◽  
Female Genital Tract ◽  
Immunohistochemical Analysis ◽  
Early Stage Disease ◽  
Pelvic Mri ◽  
Primary Surgery

Endometrial carcinoma is the most common neoplasia of female genital tract. The prognosis of early stage disease (FIGO I and FIGO II) is excellent: recurrence after surgery is less than 15%, most of which are reported within 3 years after primary treatment. Herein we report a case of late rectal recurrence from FIGO Ib endometrial adenocarcinoma. Patient had also familiar and personal history of colonic adenocarcinoma and previous findings of microsatellite instability (MSI); molecular analysis evidenced heterozygotic somatic mutation in MLH1 gene. Twenty-eight years after hysterectomy and bilateral salpingoovariectomy, a rectal wall mass was detected during routine colonoscopy. Patients underwent CT scan, pelvic MRI, and rectal EUS with FNA: histopathological and immunohistochemical analysis revealed differentiated carcinoma cells of endometrial origin. No neoadjuvant treatment was planned and low rectal anterior resection with protective colostomy was performed; histology confirmed rectal lesion as metastasis from endometrial carcinoma. Recurrence of early stage endometrial carcinoma after a long period from primary surgery is possible. It is important to keep in mind this possibility in order to set a correct diagnostic and therapeutic algorithm, including preoperative immunohistochemical staining, and to plan a prolonged follow-up program.

Abstract WP434: The SAH score: An Outcome prediction model

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Neeraj S Naval ◽  
Robert Kowalski ◽  
Tiffany Chang ◽  
Filissa Caserta ◽  
Juan R Carhuapoma ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Prediction Model ◽  
Outcome Prediction ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Multiple Logistic Regression Analysis ◽  
Univariate Analysis ◽  
Area Under The Curve ◽  
Risk Of Mortality ◽  
Relationship Of ◽  
Admission Variables

Objective: To create a reliable model for predicting mortality following aneurysmal subarachnoid hemorrhage (aSAH) based on admission variables. Background: Hunt & Hess grade is commonly used as a grading scale to predict mortality following aSAH. The scale relies only on clinical presentation and does not incorporate other admission factors making it suboptimal for outcome prediction. Methods: Prospectively collected data of aSAH patients admitted to our institution between 1991-2009 were reviewed. We analyzed factors that impacted in-hospital SAH mortality following multiple logistic regression analysis. Scores were ‘weighted’ based on relative risk of mortality following stratification of each of these variables. Hunt & Hess grade was subdivided into grades I/II, III, IV and V; age was split into 4 subgroups: 18-49, 50-69, 70-79 and >80. Medical co-morbidities were subdivided into none, 1 or >/=2 based on co-morbidities derived either from Charlson index or other factors (hypertension, cocaine) historically known to impact SAH outcomes, only if they were associated with increased mortality on univariate analysis. Results: 1134 patients were included; all-cause SAH hospital mortality was 18.3%. Hunt & Hess Grade, age and medical co-morbidities significantly impacted mortality following multivariate analysis (P< 0.05). Association with mortality based on Hunt & Hess Grade was 7%(I/II; score 0), 16%(III; score 1), 31%(IV; score 2) and 65%(V; score 4). Mortality based on age was 13%(18-49; score 0), 18%(50-69; score 1), 34% (70-79; score 2) and 46% (>80; score 3). Relationship of co-morbidities and mortality was 9%(none; score 0), 17%(one; score 1) and 32%(two/more; score 2). Summated Scores ranged from 0-9 with progressively increasing mortality at higher scores (0=1%/ 1=4%/ 2=9%/ 3=13%/ 4=22%/ 5=52%/ 6=77%/ 7=88%/ 8=100%/ 9=100%). PPV for scores in the range 7-9 was 90%; 6-9 was 83%. NPV for range 0-3 was 93% and 0-4 was 91%. The area under the curve (AUC) was 0.825 (good accuracy), which was superior to Hunt & Hess Grade (AUC 0.775, fair accuracy). Conclusions: The SAH score is a more accurate prediction model than the Hunt & Hess grade in estimating likelihood of hospital mortality following SAH.

Immunocytochemical localization of β1-4 galactosyltransferase in endometrial carcinoma cells

1990 ◽  
Vol 48 (3) ◽  
pp. 944-945
Author(s):  
Ichiro Yamamoto ◽  
Toshiaki Tachibana ◽  
Hiroko Maruyama ◽  
Noriyuki Komatsu ◽  
Hiroyuki Kuramoto ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Cell Lines ◽  
Endometrial Adenocarcinoma ◽  
Protein A ◽  
Rabbit Antiserum ◽  
Carcinoma Cells ◽  
Affinity Column ◽  
Antibody Technique ◽  
Galactosyl Transferase ◽  
C Terminus

We have paid attention to the alteration of glycosyltransferase in carcinoma cells, because it might be related to the malignancy of the cells. In this connection, localization of β1-4 galactosyl transferase (β1-4 Gal T) in human endometrial carcinoma cells was examined immunocytochemically using two kinds of cell lines, each of which showed different degree of differentiation.An antibody was purified from the rabbit antiserum against the synthetic peptide, IFNRLVFRGMSC (W89) of human β1-4 Gal T coupled with KLH (keyhole limpet hemocyanine) by protein A column and peptide-affinity column chromatography. The anti-W89 serum reacts to the C-terminus of human β 1-4 Gal T and to both membrane-bound and soluble forms of the enzyme. Cell line of well differentiated endometrial adenocarcinoma (I) and that of poorly differentiated endometrial adenocarcinoma (50B) were cultivated respectively in MEM medium containing 15% FCS and 2 mM glutamine for 4 d at 37°C under 5% CO2. The cells were fixed in a mixture of 4% paraformaldehyde and 0.1% glutaraldehyde in 0.1 M Soerensen’s phosphate buffer (pH 7.4) at 4°C for 30 min, washed with PBS, then freezed and thawed. The indirect method of the peroxidase- labeled antibody technique was used for immunocytochemistry of both LM and TEM on the cell lines. The cells were dehydrated in ethanol and embedded in TAAB 812. Ultrathin sections were observed under a TEM, JEM-100S.

PROGESTERONE AND PROGESTATIONAL COMPOUNDS IN THE TREATMENT OF ADVANCED ENDOMETRIAL CARCINOMA

1965 ◽  
Vol 49 (3) ◽  
pp. 412-426 ◽  
Author(s):  
Per Bergsjö
Keyword(s):  
Endometrial Carcinoma ◽  
Lung Metastases ◽  
Endometrial Adenocarcinoma ◽  
Cervical Adenocarcinoma ◽  
Tumour Tissue ◽  
Pelvic Tumour ◽  
Histological Alterations

ABSTRACT Various doses of progesterone in oil and of two progestational compounds (17α-hydroxy-19-nor-progesterone caproate and 17α-hydroxyprogesterone p-butoxyphenyl propionate) have been given to 15 patients with recurrent and/or metastatic endometrial adenocarcinoma and to one patient with metastatic cervical adenocarcinoma, for periods of up to 27 weeks. Regression of lung metastases was noted in 4 of 13 patients, softening of pelvic tumour in 2 of 4, and histological alterations of tumour tissue in 4 of 5 patients. In the patient with metastases from a cervical adenocarcinoma, the disease progressed during the treatment. The significance of the observations is discussed.

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