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Selected immunohistochemical prognostic factors of endometrial cancer


Authors: I. Marková;  M. Lubušký;  M. Procházka;  M. Kudela;  M. Dušková;  J. Zapletalová;  R. Pilka
Authors‘ workplace: Ústav genetiky a fetální medicíny, LF UP a UP Olomouc, Porodnicko‑gynekologická klinika, LF UP a UP Olomouc, Ústav patologické anatomie, LF UP a UP Olomouc, Ústav lékařské biofyziky, pracoviště biometrie, UP Olomouc
Published in: Prakt Gyn 2010; 14(1): 14-21
Category: Original Article

Overview

Objective:
To assess the immunohistochemical expression of p53, bcl- 2, c- erbB- 2, Ki- 67, estrogen (ER) and progesterone (PR) receptors, matrix metalloproteinase- 7 (MMP- 7) and matrix metalloproteinase- 26 (MMP- 26) in endometrial cancer patients. To assess the relation between steroid receptor positivity and other markers. Design: Experimental prospective study. Setting: Department of Obstetrics and Gynecology, Department of Genetics, Department of Pathology, Palacky University Medical School and University Hospital, Olomouc. Methods: We studied 144 cases of primary untreated endometrial carcinoma in which the p53, bcl- 2, c- erbB- 2, Ki- 67, ER, PR, MMP- 7 and MMP- 26 antigens were investigated with the use of immunohistochemical methods. We evaluated the correlations between immunohistochemical staining and the age, FIGO stage, grading, depth of invasion and metastatic spread to lymph nodes. Results: Mean age was 65.7 years (range 34– 90). p53, bcl- 2, c- erbB- 2, Ki- 67, ER, PR were positive in 35 (24.3 %), 100 (69.4 %), 41 (28.4 %), 65 (45.1 %), 115 (79.8 %) and 127 (88.1 %) cases respectively. MMPs were evaluated in a group of 70 patients, MMP- 7 was positive in 33 (47.1 %), MMP- 26 in 40 (57.1 %) cases. MMP- 7 expression decreased with higher patient age. p53 and Ki- 67 overexpression was found to be related to poor differentiation. Immunostaining for bcl- 2 correlated with the positivity of steroid receptors status, while immunostaining for c- erbB- 2 correlated inversely with ER positive group of cases. Conclusion: The overexpression of p53 and Ki- 67 seems to indicate a more malignant phenotype, while bcl- 2 expression in dependence on steroid receptor positivity could contribute to the identification of high‑risk tumors.

Key words:
endometrial cancer –  immunohistochemistry –  prognostic factors


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