CD44 expression in papillary serous endometrial carcinoma

2003 ◽  
Vol 13 (4) ◽  
pp. 480-484 ◽  
Author(s):  
S. Hosford ◽  
J. Elliott ◽  
Z.-W. Ma ◽  
R. Majeste ◽  
B. Dubeshter
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
Myometrial Invasion ◽  
Cervical Cytology ◽  
Tumor Type ◽  
Nodal Metastases ◽  
Malignant Cells ◽  
Clinicopathologic Features ◽  
Tumor Spread ◽  
Cd44 Expression

The objective of this paper is to evaluate the relationship between CD44 expression and the clinicopathologic features of papillary serous endometrial cancer. CD44 expression was assessed in 32 cases of papillary serous endometrial carcinoma by standard immunohistochemical staining techniques. Clinicopathologic features including myometrial invasion, nodal metastases, tumor spread, stage, and the shedding of malignant cells on cervical cytology were reviewed. The Chi-square test was used for statistical analysis.CD44 was not expressed in 81% of patients with papillary serous endometrial carcinoma. Malignant cells were seen on cervical cytology in 68% of all cases with significantly more in the CD44-negative group (78% vs. 33%, P 0.05). CD44 expression was not related to stage, myometrial invasion, nodal involvement, or intraperitoneal spread. We conclude that the cell adhesion molecule CD44 is expressed infrequently in papillary serous endometrial carcinoma. Shedding of malignant cells on cervical cytology is common in papillary serous endometrial cancer and occurs more frequently in CD44-negative cases. CD44 expression doesn't appear to be related to known prognostic features such as nodal metastases or stage. The biologic aggressiveness of this tumor type may, in part, be related to its lack of CD44 expression.

Evaluation of endometrial carcinoma on magnetic resonance imaging

2007 ◽  
Vol 17 (1) ◽  
pp. 188-196 ◽  
Author(s):  
A. G. Rockall ◽  
R. Meroni ◽  
S. A. Sohaib ◽  
K. Reynolds ◽  
F. Alexander-Sefre ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Endometrial Carcinoma ◽  
Diagnostic Performance ◽  
Myometrial Invasion ◽  
Imaging Features ◽  
Nodal Metastases ◽  
Resonance Imaging ◽  
Predictive Values ◽  
Sensitivity Specificity

Our aims were to assess diagnostic performance of T2-weighted (T2W) and dynamic gadolinium-enhanced T1-weighted (T1W) magnetic resonance imaging (MRI) in the preoperative assessment of myometrial and cervical invasion by endometrial carcinoma and to identify imaging features that predict nodal metastases. Two radiologists retrospectively reviewed MR images of 96 patients with endometrial carcinoma. Tumor size, depth of myometrial and cervical invasion, and nodal enlargement were recorded and then correlated with histology. The sensitivity, specificity, positive and negative predictive values (PPV and NPV) for the identification of any myometrial invasion (superficial or deep) were 0.94, 0.50, 0.93, 0.55 on T2W and 0.92, 0.50, 0.92, 0.50 on dynamic T1W, and for deep myometrial invasion were 0.84, 0.78, 0.65, 0.91 on T2W and 0.72, 0.88, 0.72, 0.88 on dynamic T1W. The sensitivity, specificity, PPV and NPV for any cervical invasion (endocervical or stromal) were 0.65, 0.87, 0.57, 0.90 on T2W and 0.50, 0.90, 0.46, 0.92 on dynamic T1W, and for cervical stromal involvement were 0.69, 0.95, 0.69, 0.95 on T2W and 0.50, 0.96, 0.57, 0.95 on dynamic T1W. Leiomyoma or adenomyosis were seen in 73% of misdiagnosed cases. Sensitivity and specificity for the detection of nodal metastases was 66% and 73%, respectively. Fifty percent of patients with cervical invasion on MRI had nodal metastases. In conclusion, MRI has a high sensitivity for detecting myometrial invasion and a high NPV for deep invasion. MRI has a high specificity and NPV for detecting cervical invasion. Dynamic enhancement did not improve diagnostic performance. MRI may allow accurate categorization of cases into low- or high-risk groups ensuring suitable extent of surgery and adjuvant therapy

scholarly journals The effect of myometrial invasion on prognostic factors and survival analysis in endometrial carcinoma

1970 ◽  
Vol 19 (4) ◽  
pp. 3235-3241
Author(s):  
Cem Dane ◽  
Sait Bakir
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Prognostic Factors ◽  
Survival Rate ◽  
Endometrial Carcinoma ◽  
Myometrial Invasion ◽  
Stage Iv ◽  
Progression Free Survival ◽  
Free Survival ◽  
The Relationship

Background: We investigated the relationship between myometrial invasion and the prognostic factors on overall and progression free survival in endometrial carcinoma.Methods: 122 cases operated with endometrial cancer were included into the study. Progression-free survival and overall survival were evaluated according to degree of myometrial invasion. We also investigated the relationship between myometrial invasion and prognostic factors. Results: The 5- year progression-free survival rate was 90 % in stage I, 66 % in stage II, 32 % in stage III and 60 % in stage IV. The 5- year overall survival rate was 95 % in stage I, 89 % in stage II, 49 % in stage III and 30 % in stage IV. The progression free survival and overall survival for patients with more than 50 % myometrial invasion were detected 67 % at 58 months and 66 % at 60 months, respectively. The clinicopathological variables that significantly correlated with myometrial invasion of more than 50 % were as follows: pelvic lymph node metastasis (p: 0,00029-OR: 11.2), cervical stromal invasion (p: 0008-OR:7.9), LVSI (p< 0.0001-OR: 16.5).Conclusion: The depth of myometrial invasion is one of the most important prognostic indicators and determinants of therapy in endometrial cancer. Keywords: Endometrial carcinoma; Progression free survival; Overall survival; Prognostic factors.

Independent prognostic factors in endometrial cancer: a single institution review

Open Medicine ◽  
2011 ◽  
Vol 6 (3) ◽  
pp. 294-299
Author(s):  
P. Uharček ◽  
M. Mlynček ◽  
J. Ravinger ◽  
E. Lajtman ◽  
M. Matejka
Keyword(s):  
Endometrial Cancer ◽  
Prognostic Factors ◽  
Myometrial Invasion ◽  
Stage Iv ◽  
Tumor Grade ◽  
Clinical History ◽  
Figo Stage ◽  
Nodal Status ◽  
Treatment Modalities ◽  
Tumor Type

AbstractThe purpose of this study was to conduct a clinical and pathologic review of endometrial cancers diagnosed and surgically treated in our institution to evaluate results of treatment in relation to current international recommendations. We retrospectively evaluated the clinical history, treatment and follow-up of patients with histologically confirmed endometrial cancer treated in Faculty Hospital Nitra, Slovakia from 1990 to 2005. Data were abstracted regarding tumor histology, grade, age, parity, stage, diabetes, use of oral contraceptives, BMI, survival and treatment modalities including surgery, radiation therapy, chemotherapy, hormonal therapy, and combinations thereof. One hundred and thirty nine patients received surgical treatment for endometrial cancer: stage I -101 (72,6%), stage II - 9 (6,5%), stage III - 23 (16,6%) and stage IV - 6 (4,3%). Tumors were well differentiated in 87(62,6%), moderately differentiated in 32 (23%) and poorly differentiated in 20 (14,4%). There were 45 (32,4%) premenopausal patients and 94 (67,6%) postmenopausal. In multivariate statistical analysis we identified FIGO stage, tumor type, tumor grade, nodal status and depth of myometrial invasion as independent prognostic factors for overall survival, and FIGO stage, nodal status, and tumor grade as independent prognostic factors for recurrence-free interval.

scholarly journals Endometrial Carcinoma staging Issues Laparotomy versus Laparoscopic Approach which is More Feasible and Safer?

2019 ◽  
Vol 4 (2) ◽  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
Uterine Cancer ◽  
Surgical Staging ◽  
Peritoneal Cytology ◽  
Tumor Type ◽  
Statistical Significant Difference ◽  
Conversion Rates ◽  
Hospitalization Period ◽  
Significant Difference

Background: Surgical staging of endometrial cancer is considered one of the main pathways for managing those categories of cases. Uterine cancers are considered a challenging surgical scenario in many situations due to anatomical changes in tissue planes and metastatic disease besides the presence of obesity in many cases requiring management. Aim: To compare laparoscopy versus laparotomy for complete uterine cancer surgical staging. Methodology: Cases having clinical stage I to IIA endometrial carcinoma have been randomly allocated to laparoscopy or open laparotomy including hysterectomy, salpingo - oophorectomy, pelvic cytology, pelvic and para-aortic lymphadenectomy. The chief research study outcomes were the 6-week morbidity, mortality issues, hospitalization period and conversion rates from laparoscopy to laparotomy. Results: There was no statistical significant difference as regards the Surgical stage, tumor type, types and numbers of nodes of the studied research groups in which there was no statistical significant difference as regards surgical staging, tumor type observed, peritoneal cytology, type of nodes, no nodes, Para aortic nodes only, pelvic nodes only, both pelvic and para - aortic nodes, any pelvic node, no. of nodes median (IQR) values = 0.996, 0.998, 0.929, 0.607, 0.928, 0.669, 0.541, 0.562, 0.680, 0.934 consecutively. Conclusions and recommendations: The current research elucidates the privilege of laparoscopic surgical staging for early stage endometrial cancer, however future research studies are required to be performed in multi centric fashion and to put in consideration variability’s in BMI, coexisting medical morbidities e.g. DM, hypertension besides the racial and ethnic differences

scholarly journals Understanding the role of indoleamine-2,3-dioxygenase and stromal differentiation in rare subtype endometrial cancer

Rare Tumors ◽  
2021 ◽  
Vol 13 ◽  
pp. 203636132110446
Author(s):  
Dongling Wu ◽  
Sean Hacking ◽  
Jin Cao ◽  
Mansoor Nasim
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
Immune Cell ◽  
Disease Free Survival ◽  
Myometrial Invasion ◽  
Tumor Stage ◽  
Free Survival ◽  
Indoleamine 2,3 Dioxygenase ◽  
Disease Free

Endometrial cancer (EC) is a disease with good and poor prognostic subtypes. Dedifferentiated endometrial carcinoma (DEC), undifferentiated endometrial carcinoma (UEC), and clear cell endometrial carcinoma (CEC) are rare high-grade tumors, associated with a poor prognosis and high pathologic stage. Many studies have been performed on the programmed death-ligand 1 (PD-L1) axis mainly focus on endometrioid adenocarcinomas and little research has been done on rare subtypes. The present body of work aims to evaluate the role of indoleamine-2,3-dioxygenase (IDO-1) and stromal differentiation (SD), their correlation with clinicopathologic features and overall survival. Here we found that positive IDO-1 expression in immune cells correlated with worse disease-free survival ( p = 0.02), recurrence ( p = 0.03), high pathologic tumor stage ( p = 0.024), lymph node metastasis ( p = 0.028), and myometrial invasion ( p = 0.03). Our findings suggest IDO-1 to be relevant in both MMR intact and deficient tumors; however, >20% immune cell staining was restricted to MMR deficient cancers. For the stroma, immature, myxoid differentiation was found to correlate with worse disease-free survival ( p = 0.04). We also found the correlation between IDO-1 expression and immature stroma. Looking forward, IDO-1 could be promising for immunotherapy and SD could be the answer to clinical heterogeneity.

scholarly journals High resolution diffusion-weighted imaging with readout segmentation of long variable echo-trains for determining myometrial invasion in endometrial carcinoma

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mengnv Xie ◽  
Zhen Ren ◽  
Dujun Bian ◽  
Dan Li ◽  
Li Yu ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Image Quality ◽  
Endometrial Carcinoma ◽  
Predictive Value ◽  
Diffusion Weighted Imaging ◽  
Myometrial Invasion ◽  
Single Shot ◽  
Diffusion Weighted ◽  
Noise Ratio

Abstract Background We assessed the image quality of endometrial cancer lesions by readout segmentation of long variable echo-trains (RESOLVE) diffusion-weighted imaging (DWI) compared with that by single-shot echo-planar imaging (SS-EPI) DWI, aimed to explore the value of RESOLVE DWI for determining myometrial invasion and clinical stage in endometrial cancer. Materials and methods From April 2017 to March 2018, a total of 30 endometrial cancer patients (mean age 52.8 ± 9.0 years), who had undergone RESOLVE DWI and SS-EPI DWI, were included in the study. The image quality of endometrial carcinoma by two kinds of DWI scanning methods was compared qualitatively and quantitatively. The Spearman rank correlation test was used to assess the correlation of qualitative image quality scores between two readers. The accuracy of two DWI methods in detecting myometrial invasion and staging of endometrial carcinoma was calculated according to postoperative pathological results. The indexes were analyzed including sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV). Results The qualitative score of RESOLVE DWI group was superior to SS-EPI DWI group in every aspect of five aspects (all P < 0.001). Interobserver agreement of depiction was good or excellent in two DWI sequences. Signal to noise ratio and contrast to noise ratio values in RESOLVE DWI group were both higher than those in SS-EPI DWI group (P<0.001). No statistical difference of apparent diffusion coefficient value was observed between two DWI groups (P = 0.261). The specificity, accuracy, PPV, and NPV of estimating myometrial invasion by RESOLVE DWI in three cases (intramucosal lesion, <50% superficial invasion and ≥ 50% deep invasion) were all higher than those by SS-EPI DWI for endometrial carcinoma. Especially RESOLVE DWI was valuable in judging <50% superficial invasion (95%CI:0.586, 0.970). No significant difference in accuracy staging was between the two DWI groups (P = 0.125). Conclusion RESOLVE DWI can provide higher quality images of endometrial carcinoma than SS-EPI DWI. The high-quality images are helpful for precise assessment of myometrial invasion in endometrial cancer.

DTI histogram parameters correlate with the extent of myoinvasion and tumor type in endometrial carcinoma: a preliminary analysis

2019 ◽  
Vol 61 (5) ◽  
pp. 675-684
Author(s):  
Adarsh Ghosh ◽  
Tulika Singh ◽  
Veenu Singla ◽  
Rashmi Bagga ◽  
Radhika Srinivasan ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
Endometrial Carcinoma ◽  
Fractional Anisotropy ◽  
Diffusion Tensor ◽  
Characteristic Curve ◽  
Mean Diffusivity ◽  
Area Under The Curve ◽  
Myometrial Invasion ◽  
Tumor Type ◽  
Planar Imaging

Background Myoinvasion and tumor-type determines surgical planning in endometrial carcinoma. Purpose To evaluate whole tumor diffusion tensor imaging histogram texture parameters in evaluating myoinvasion and tumor type in endometrial carcinoma. Material and Methods Twenty-seven patients with endometrial carcinoma underwent diffusion tensor imaging on a 1.5-T MRI system using echo-planar imaging sequence with 0 and 700 s/mm2 b values. Whole tumor histogram parameters were obtained from fractional anisotropy, mean diffusivity maps. Mann–Whitney U test and receiver operating characteristic curve analyses were used Results The mean fractional anisotropy of tumors with no myoinvasion was significantly higher than tumors which underwent myoinvasion, suggesting higher anisotropy in tumors which did not invade the myometrium. Voxel-wise heterogeneity in distribution of fractional anisotropy and mean diffusivity was seen in the form of higher uniformity and lower entropy of tumors with superficial <50% myoinvasion versus >50% myoinvasion. Uniformity, entropy, and energy of voxel-wise fractional anisotropy distribution gave an area under the curve of 0.827, 0.821, and 0.796, respectively, in predicting the presence of deep myometrial invasion while energy, entropy, and uniformity of mean diffusivity distribution in tumor gave an area under the curve of 0.84, 0.815, and 0.809 respectively. Tumor type was predicted with an area under the curve of 0.747, 0.759, and 0.765 for the uniformity, energy, and entropy of voxel-wise fractional anisotropy distribution. A logistic regression combining all the important histogram parameters obtained 94% and 88% sensitivity and 88% and 80% specificity in predicting deep myoinvasion and tumor type, respectively. Conclusion Diffusion tensor histogram analysis can better characterize endometrial carcinomas and can be used as a quantitative marker of tumor behavior.

Second Opinion Expert Pathology in Endometrial Cancer: Potential Clinical Implications

2017 ◽  
Vol 27 (2) ◽  
pp. 289-296 ◽  
Author(s):  
Friederike Grevenkamp ◽  
Felix Kommoss ◽  
Friedrich Kommoss ◽  
Sigurd Lax ◽  
Falko Fend ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
Clinical Relevance ◽  
Second Opinion ◽  
World Health ◽  
Clinical Implications ◽  
Pathology Report ◽  
Low Grade ◽  
Tumor Type ◽  
Case Review

ObjectiveIn cancer patients, the pathology report serves as an important basis for treatment. Therefore, a correct cancer diagnosis is crucial, and diagnostic discrepancies may be of clinical relevance. It was the aim of this study to perform a specialized histopathology review and to investigate potential clinical implications of expert second opinion pathology in endometrial cancer.MethodsPatients treated for endometrial carcinoma at the Tübingen University Women's hospital between 2003 and 2013 were identified. Original pathology reports were reviewed, and contributing pathologists were asked to submit original slides and paraffin blocks. Case review was subsequently performed by 3 pathologists specialized in gynecological pathology who were blinded for clinical information. For histological typing, the World Health Organization 2014 classification was used, grading and staging were performed according to International Federation of Gynecology and Obstetrics 2009. Risk assignment was performed based on the 2013 European Society for Medical Oncology clinical practice guidelines.ResultsIn 565 of 745 cases, which had originally been diagnosed as endometrial carcinoma, archival histological slides and blocks were available. In 55 (9.7%) of 565 cases, a major diagnostic discrepancy of potential clinical relevance was found after expert review. In 38 of these 55 cases, the diagnostic discrepancy was related to tumor type (n = 24), grade (n = 10) or myoinvasion (n = 4). In 17 cases, the diagnosis of endometrial carcinoma could not be confirmed (atypical hyperplasia, n = 10; endometrial carcinosarcoma, n = 4; neuroendocrine carcinoma, n = 1; leiomyosarcoma, n = 1; atypical polypoid adenomyoma, n = 1). Minor discrepancies not changing risk classification were also noted in 214 (37.9%) of 565, most frequently for grade within the low-grade (G1/G2) category (n = 184).ConclusionsA retrospective gynecopathological case review was shown to reveal limited but significant discrepancies in histological diagnoses as well as typing and grading of endometrial carcinomas, some directly impacting clinical management. Second opinion pathology therefore not only helps to improve the quality of translational research study cohorts but might also help to optimize patient care in difficult cases.

scholarly journals Low Expression of Stanniocalcin 1 (STC-1) Protein Is Associated With Poor Clinicopathologic Features of Endometrial Cancer

2021 ◽  
Vol 27 ◽  
Author(s):  
Masuma Khatun ◽  
Elina Urpilainen ◽  
Anne Ahtikoski ◽  
Riikka K. Arffman ◽  
Annukka Pasanen ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Stress Responses ◽  
Myometrial Invasion ◽  
Clinicopathologic Features ◽  
Obese Women ◽  
Glycoprotein Hormone ◽  
Large Tumor ◽  
Tissue Samples ◽  
Dna Mismatch ◽  
Endometrial Epithelium

Stanniocalcin-1 (STC-1) is a glycoprotein hormone involved in diverse biological processes, including regulation of calcium phosphate homeostasis, cell proliferation, apoptosis, inflammation, oxidative stress responses, and cancer development. The role of STC-1 in endometrial cancer (EC) is yet to be elucidated. In this study, we investigated the protein expression pattern of STC-1 in a tissue microarray (TMA) cohort of hysterectomy specimens from 832 patients with EC. We then evaluated the prognostic value of STC-1 expression regarding the clinicopathologic features and patients survival over a period of 140 months. Our results revealed that in EC tissue samples, STC-1 is mainly localized in the endometrial epithelium, although some expression was also observed in the stroma. Decreased STC-1 expression was associated with factors relating to a worse prognosis, such as grade 3 endometrioid tumors (p = 0.030), deep myometrial invasion (p = 0.003), lymphovascular space invasion (p = 0.050), and large tumor size (p = 0.001). Moreover, STC-1 expression was decreased in tumors obtained from obese women (p = 0.014) and in women with diabetes mellitus type 2 (DMT2; p = 0.001). Interestingly, the data also showed an association between DNA mismatch repair (MMR) deficiency and weak STC-1 expression, specifically in the endometrial epithelium (p = 0.048). No association was observed between STC-1 expression and disease-specific survival. As STC-1 expression was particularly low in cases with obesity and DMT2 in the TMA cohort, we also evaluated the correlation between metformin use and STC-1 expression in an additional EC cohort that only included women with DMT2 (n = 111). The analysis showed no difference in STC-1 expression in either the epithelium or the stroma in women undergoing metformin therapy compared to metformin non-users. Overall, our data may suggest a favorable role for STC-1 in EC behavior; however, further studies are required to elucidate the detailed mechanism and possible applications to cancer treatment.

scholarly journals Mesonephric (clear cell) endometrial cancer

2012 ◽  
Vol 61 (5) ◽  
pp. 85-91 ◽  
Author(s):  
Elena Aleksandrovna Ulrikh ◽  
Dzhamilat Ilyasovna Khalimbekova ◽  
Adiliya Fettekhovna Urmancheyeva ◽  
Dmitriy Yevgenyevich Matsko ◽  
Vakhtang Mikhaylovich Merabishvili
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
Cancer Registry ◽  
Clear Cell ◽  
Myometrial Invasion ◽  
Registry Data ◽  
High Rate ◽  
Saint Petersburg ◽  
Cancer Registry Data ◽  
Research Institute

Clear Cell Endometrial Cancer is a rare nonendometrioid endometrial carcinoma detected in 1–6 %. The aim of the study was to determine clinical and morphologic features of Clear Cell Endometrial Cancer. Materials: All the cases with Clear Cell Endometrial Cancer treated in the N. N. Petrov Research Institute of Oncology (Saint-Petersburg) were identified from surgical pathology files from 1985 to 2010 years. Saint-Petersburg Population Cancer Registry data (2000–2005 years period) and N. N. Petrov Research Institute of Oncology Hospital Cancer Registry data (1985–2010 years period) were analyzed. The population based study included 3 224 cases of endometrial cancer patients, the hospital study — 3 345 patients. Results: A review of 3 345 cases of endometrial cancer revealed 73 cases (2.2 %) of Clear Cell Endometrial Cancer. Clear Cell Endometrial Cancer registered in elder women with late menopause and atrophic endometrium. The tumor is a highly malignant variant of endometrial carcinoma with deep myometrial invasion (42.5 %), high rate of metastasis (39.1 %) even in cases with superficial invasion (23.0 %) versus endometrioid endometrial cancer: 6.0 %, 14.2 % and 9.0 % respectively. Clear Cell Endometrial Cancer has a poor prognosis with 3-year observed survival 62.7 %, 5-year observed survival — 52.2 % (Saint-Petersburg Population Cancer Registry), 70.9 % (3-year survival) and 61.8 % (5-year survival) according to the N. N. Petrov Research Institute of Oncology Hospital Cancer Registry data. Whereas prognosis in patients with endometrioid endometrial carcinoma is much more favorable: 3-year observed survival 79.4 %, 5-year observed survival — 75.5 %

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