Sonographic and histopathologic characteristics of MMR-deficient endometrial cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17111-e17111
Author(s):  
Daniel Arnold Smith ◽  
Raj M Paspulati ◽  
Nami R Azar ◽  
Kai Laukamp ◽  
Elias Kikano ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Thickness ◽  
Color Doppler ◽  
Transvaginal Ultrasound ◽  
Myometrial Invasion ◽  
Figo Stage ◽  
Initial Presentation ◽  
Chi Square ◽  
Ultrasound Findings ◽  
Endometrial Cancers

e17111 Background: Mismatch repair (MMR) deficiency has emerged as a key biomarker in endometrial cancer with roles in prognosis and guiding therapy. However, the differences of sonographic features between MMR-deficient and MMR-proficient endometrial cancers at initial presentation have not been established. Methods: Transvaginal ultrasound studies of 103 endometrial cancers (60 MMR-deficient, 43 MMR-proficient) at initial presentation were retrospectively analyzed by two experienced radiologists. Histopathologic findings and sonographic features of endometrial morphology recorded according to IETA terminology were compared using Likelihood Ratio Chi-Square and Mann–Whitney U tests. Results: The MMR-deficient group comprised of 90% and the MMR-proficient group of 100% endometrioid subtypes. The following sonographic features were statistically different between MMR-deficient (age 45-95) and MMR-proficient (age 45-83) groups: uniform endometrial echogenicity/pattern, non-uniform endometrial echogenicity/pattern, endometrial midline morphology, presence of a bright edge, and endomyometrial junction morphology. Ultrasound findings of endometrial thickness, synechiae, intracavitary fluid, color Doppler score, and vascular pattern were not significantly different. Statistically significant differences in pathology features included FIGO grade, myometrial invasion, and lymphovascular invasion, while FIGO stage showed no difference. Conclusions: MMR-deficient endometrial cancer is characterized by several statistically different ultrasound and histopathologic features on initial presentation compared to MMR-proficient endometrial cancer.[Table: see text]

Heparanase expression in both normal endometrium and endometrial cancer

2006 ◽  
Vol 16 (3) ◽  
pp. 1401-1406 ◽  
Author(s):  
J. Kodama ◽  
T. Kusumoto ◽  
N. Seki ◽  
T. Matsuo ◽  
Y. Ojima ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Survival Rates ◽  
Myometrial Invasion ◽  
Immunohistochemical Analysis ◽  
Figo Stage ◽  
Peritoneal Cytology ◽  
Normal Endometrium ◽  
Deep Myometrial Invasion ◽  
Endometrial Cancers ◽  
The Relationship

The aim of this study was to investigate the relationship between heparanase expression and prognostic factors in endometrial cancer, as well as the relationship between heparanase expression during phases of the normal endometrial cycle. Immunohistochemical analysis of 166 endometrial cancers and 34 normal endometria in various phases of growth was performed. The heparanase expression in the late-proliferative phase of normal endometria was found to be significantly higher than in either the early-proliferative or the secretory phases (P = .012 and P = .044, respectively). Heparanase expression was also significantly higher in endometrial cancer patients with tumors of an advanced FIGO stage (P = .0003) and high FIGO grade (P = .004) and with cancers showing either deep myometrial invasion (P = .023), lymph node metastasis (P = .006), lymphvascular space involvement (P = .048), or positive peritoneal cytology (P = .010). The disease-free and overall survival rates of patients with intense heparanase expression were significantly lower than those of patients with absent or moderate heparanase expression (P = .004 and P = .002, respectively). Heparanase may participate in normal endometrial remodeling and can serve as an indicator of the aggressive potential and poor prognosis of endometrial cancers.

The role of transvaginal ultrasound in early diagnosis of tamoxifen-related endometrial cancer: An Italian experience

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 11021-11021
Author(s):  
F. Martella ◽  
P. G. Giannessi ◽  
L. Coltelli ◽  
N. Giuntini ◽  
V. Safina ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Figo Stage ◽  
Published Data ◽  
Italian Experience ◽  
Increased Risk ◽  
Er Positive ◽  
Benign Histology ◽  
Common Clinical Practice

11021 Background: women treated with tamoxifen for ER-positive early breast cancer are at a two to seven fold increased risk of endometrial cancer. Even though published data fail to support the use of transvaginal ultrasound (TVU) for screening of endometrial cancer, this is still a very common clinical practice in this subset of patients (pts). Methods: we have conducted a retrospective analysis to investigate the value of TVU in early detection of tamoxifen-related endometrial cancer. The screened population consists of pts treated with adjuvant tamoxifen in our institution from January 1999 up to December 2003 receiving a TVU annually or in case of gynaecologic symptoms. Results: 491 evaluated pts performed a total of 1634 TVUs in asymptomatic conditions. FIGO stage I endometrial cancers have been diagnosed in 3 patients (0.32%) who are still alive after total hysterectomy. A vaginal bleeding anticipated the examination in 33 women (3.2%) and represented the first symptom in two cases of tumor. Only one endometrial cancer has been detected with the screening procedure. Median increase of endometrial thickness has been 7.6 mm (range 1–34 mm) and those patients with abnormal images at TVU underwent an hysteroscopy with endometrial biopsies (169) resulting in a benign histology (polyps, cystic atrophy, hyperplasia) in most cases. Conclusions: therefore we have performed more than 1500 transvaginal ultrasound to detect only one asymptomatic cancer so we agree with literature in supporting that women receiving tamoxifen should undergo only an annual gynaecologic examination reserving the TVU to patients with vaginal bleedings or discharges. No significant financial relationships to disclose.

Heparanase expression and angiogenesis in endometrial cancer: Analyses of RT-PCR and immunohistochemistry

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5535-5535
Author(s):  
Y. Aoki ◽  
M. Inamine ◽  
M. Hirakawa ◽  
W. Kudaka ◽  
Y. Nagai
Keyword(s):  
Endometrial Cancer ◽  
Tumor Angiogenesis ◽  
Microvessel Density ◽  
Myometrial Invasion ◽  
Tumor Grade ◽  
Figo Stage ◽  
Clinicopathological Parameters ◽  
Strong Positive Correlation ◽  
Stage Iiic ◽  
Endometrial Cancers

5535 Background: The human heparanase has been shown to function in tumor progression, metastatic spread, and tumor angiogenesis. The aim of the present study was to assess heparanase expression in endometrial cancer in correlation with neovascularization and clinicopathological factors.Methods: Fifty-two endometrial cancers were obtained from previously untreated patients (median age, 56 years; range, 35–80 years). The expression of heparanase mRNA was evaluated using a semi-quantitative reverse transcriptase-polymerase chain reaction and immunohistochemical staining (IHC) with anti-heparanase polyclonal antibody. This antibody was raised by immunizing a rabbit with a peptide containing the amino acid residues from 238 to 250 of the Heparanase. Tumor angiogenesis was assessed using microvessel counting. The Mann-Whitney U test, one factor ANOVA test, and Spearman's test were used to determine the relationship between heparanase expression, microvessel density, and clinicopathological parameters. Results: The expression of heparanase mRNA was detected in 26 of 52 (50%) endometrial cancers, and was significantly correlated with FIGO stage IIIc (p = 0.0075), the presence of lymph-vascular space involvement (LVSI) (p = 0.0041), lymph node metastasis (LNM) (p = 0.0049), and histological tumor grade (p = 0.003). IHC showed that the heparanase was expressed in 23 of 52 (44.2%) endometrial cancers, which was significantly related to LVSI (p = 0.0028), depth of myometrial invasion (p = 0.0026), and histological tumor grade (p = 0.0135). Microvessel density was also associated with FIGO stage IIIc (p = 0.027), LVSI (p = 0.001), LNM (p = 0.038), ovarian metastasis (p = 0.03) and histological tumor grade (p = 0.003). Moreover, we found a strong positive correlation between heparanase expression and microvessel density (r2 = 0.475, p = 0.0001). Conclusions: These results suggest that the expression of heparanase can promote tumor angiogenesis and develop metastasis in endometrial cancer. No significant financial relationships to disclose.

scholarly journals Risk Assessment of Endometrial Hyperplasia or Endometrial Cancer with Simplified Ultrasound-Based Scoring Systems

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 442
Author(s):  
Norbert Stachowicz ◽  
Agata Smoleń ◽  
Michał Ciebiera ◽  
Tomasz Łoziński ◽  
Paweł Poziemski ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Hyperplasia ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Menopausal Status ◽  
Power Doppler ◽  
Uterine Cavity ◽  
Abnormal Uterine Bleeding ◽  
Scoring Systems ◽  
Diagnostic Challenge

Background: Abnormal uterine bleeding (AUB) represents a common diagnostic challenge, as it might be related to both benign and malignant conditions. Endometrial cancer may not be detected with blind uterine cavity sampling by dilatation and curettage or suction devices. Several scoring systems using different ultrasound image characteristics were recently proposed to estimate the risk of endometrial cancer (EC) in women with AUB. Aim: The aim of the present study was to externally validate the predictive value of the recently proposed scoring systems including the Risk of Endometrial Cancer scoring model (REC) for EC risk stratification. Material and methods: It was a retrospective cohort study of women with postmenopausal bleeding. From June 2012 to June 2020 we studied a group of 394 women who underwent standard transvaginal ultrasound examination followed by power Doppler intrauterine vascularity assessment. Selected ultrasound features of endometrial lesions were assessed in each patient. Results: The median age was 60.3 years (range ±10.7). The median body mass index (BMI) was 30.4 (range ± 6.0). Histological examination revealed 158 cases of endometrial hyperplasia (EH) and 236 cases of EC. Of the studied ultrasound endometrial features, the highest areas under the curve (AUCs) were found for endometrial thickness (ET) (AUC = 0.76; 95% CI: 0.71–0.81) and for interrupted endomyometrial junction (AUC = 0.70, 95% CI: 0.65–0.75). Selected scoring systems presented moderate to good predictive performance in differentiating EC and EH. The highest AUC was found for REC model (AUC = 0.75, 95% CI: 0.70–0.79) and for the basic model that included ET, Doppler score and interrupted endometrial junction (AUC = 0.77, 95% CI: 0.73–0.82). REC model was more accurate than other scoring systems and selected single features for differentiating benign hyperplasia from EC at early stages, regardless of menopausal status. Conclusions: New scoring systems, including the REC model may be used in women with AUB for more efficient differentiation between benign and malignant conditions.

Value of endometrial thickness assessed by transvaginal ultrasound for the prediction of endometrial cancer in patients with postmenopausal bleeding

2017 ◽  
Vol 296 (2) ◽  
pp. 319-326 ◽  
Author(s):  
Amelie Schramm ◽  
Florian Ebner ◽  
Emanuel Bauer ◽  
Wolfgang Janni ◽  
Ulrike Friebe-Hoffmann ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Postmenopausal Bleeding

Diagnostic Value of MicroRNA 21 in Endometrial Cancer and Benign Lesions and its Differential Expression in Relation to Clinicopathological Parameters

MicroRNA ◽  
2021 ◽  
Vol 10 ◽  
Author(s):  
Amal Bouziyane ◽  
Maryame Lamsisi ◽  
Hicham Benaguida ◽  
Mustapha Benhessou ◽  
Mohamed El Kerroumi ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Characteristic Curve ◽  
Myometrial Invasion ◽  
Figo Stage ◽  
Diagnostic Value ◽  
Clinicopathological Parameters ◽  
Benign Lesions ◽  
Tumor Tissues ◽  
Potential Biomarker ◽  
Noninvasive Samples

Background: Endometrial cancer is one of the most common malignancies among women worldwide. Although this cancer is often diagnosed at early stages, the need for biomarkers of diagnosis remains a necessity to overcome conventional invasive procedures of diagnosis. Objective: In our study, we aim to investigate the diagnostic value of microRNA-21 in endometrial cancer and its relation to clinicopathological features. Methods: We used RT-qPCR to measure the expression of microRNA-21 in 71 tumor tissues, 53 adjacent tissues, and 54 benign lesions. Results: Our results show that microRNA-21 is a potential biomarker for endometrial cancer with an area under the receiver operating characteristic curve of 0.925 (95% CI = 0.863 - 0.964, P<0.0001). The sensitivity was 84.51% (95% CI = 74.0 - 92.0) and specificity was 86.79% (95% CI = 74.7 - 94.5). For discrimination between benign lesions and controls the AUC was 0,881 with a sensitivity of 100% (95% CI = 93.4 - 100.0) and specificity of 66.04 % (95% CI = 51.7 - 78.5), and for discriminating benign lesions from tumors the AUC was 0,750 with a sensitivity of 54.93% (95% CI = 42.7 - 66.8) and specificity of 90.74% (95% CI = 79.7 - 96.9). We also found that tumors with elevated microRNA-21 expression are of advanced FIGO stage, high histological grades, and have cervical invasion, myometrial invasion and distant metastasis. Conclusion: Our findings support the important role of miR-21 as a biomarker for the diagnosis of endometrial cancer. Further studies on minimally invasive/noninvasive samples such as serum, blood, and urine are necessary to provide a better alternative to current diagnosis methods.

Characteristics of early-stage endometrial cancer and factors that influence disease recurrence.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e17567-e17567
Author(s):  
Su Yun Chung ◽  
Janice Shen ◽  
Nina Kohn ◽  
Jennifer Hernandez ◽  
Marina Frimer ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Adjuvant Therapy ◽  
Tumor Size ◽  
Early Stage ◽  
Univariate Analysis ◽  
Multivariable Analysis ◽  
Myometrial Invasion ◽  
Figo Stage ◽  
Risk Of Recurrence ◽  
Early Stage Endometrial Cancer

e17567 Background: Early-stage endometrial cancer (EEC) with FIGO stage I-II generally has a favorable prognosis and overall survival (OS). However, up to 10% of EEC patients (pts) relapse and risk factors for recurrence remain unclear. We evaluated clinical and histopathologic characteristics of EEC and correlated them with OS and recurrence free survival (RFS) through a single-center retrospective analysis. Methods: We conducted a retrospective chart review on 511 pts with EEC identified by our cancer registry from 1/1/2009 to 12/31/2019. The two main histologic groups were endometrioid adenocarcinomas (E) and other subtypes (O) including carcinosarcoma, undifferentiated, and clear cell carcinomas. Papillary serous histology was excluded. Histopathologic and clinical findings recorded included age, FIGO stage and grade, tumor size, presence of recurrence, adjuvant therapies received, percent of myometrial invasion (MI), and lymphovascular invasion (LVI). OS and RFS were estimated, and each predictor was compared using the log-rank test. The association between OS and each continuous characteristic was examined using the Cox proportional hazards model. Factors significantly associated with OS and RFS in the univariable analysis (p < 0.05) were included in a multivariable analysis to examine the joint effects of those factors on survival. Results: A total of 511 cases were reviewed. The analysis included 501 pts (E = 485, O = 16), of which 47 had recurrent disease (E = 45, O = 2) and 17 had died without recurring (E = 15, O = 2) as of their last follow-up. Overall median age was 63 years. Factors significantly associated with recurrence in the multivariable analysis were FIGO grade, (Hazard Ratios (HR): Grade 2 vs 1: 1.95, 95% CI: 1.06-3.58, p = 0.0320, Grade 3 vs 1: 2.88, 95% CI: 1.50-5.52, p = 0.0015), LVI (HR: 2.03, 95% CI: 1.10-3.75, p = 0.0244), and greater than 50% of MI (HR: 3.15, 95% CI: 1.35-7.36, p = 0.0080). The overall RFS was 92% and 86% at three and five years, respectively. On univariate analysis, among pts with a measurable tumor size (n = 446), larger tumors were not significantly associated with OS (p = 0.65) but was associated with increased recurrence (HR 1.22, 95% CI: 1.10-1.37, for a unit increase, p = 0.0003). On univariate analysis, pts who received adjuvant therapy were more likely to recur (p = 0.0002) with RFS of 86% and 76% at three and five years respectively, versus RFS of 94% and 90%, for those who did not. Conclusions: We confirmed the clinical and histopathologic characteristics that are currently considered to increase risk of recurrence in EEC. On multivariate analysis, risk of recurrence was associated with FIGO grades 2 and 3, presence of LVI, and > 50% MI. A limitation of this study is the lack of molecular analysis. Further molecular stratification may help us identify the subset of pts who are at high risk of recurrence, enabling customized adjuvant therapy in EEC.

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