Prognostic significance of clinic pathological and selected immunohistochemical factors in endometrial cancer

Czech version

Authors: I. Marková ¹; R. Pilka ²; M. Dušková ³; J. Zapletalová ⁴; Milan Kudela ²
Authors‘ workplace: Ústav genetiky a fetální medicíny, FN a LF UP, Olomouc, přednosta prof. MUDr. J. Šantavý, CSc. ¹; Porodnicko-gynekologická klinika, FN a LF UP, Olomouc, přednosta doc. MUDr. R. Pilka, Ph. D. ²; Ústav patologické anatomie, FN a LF UP, Olomouc, přednosta doc. MUDr. M. Tichý, CSc. ³; Ústav lékařské biofyziky, pracoviště biometrie, LF UP, Olomouc, přednostka doc. RNDr. H. Kolářová, CSc. ⁴
Published in: Ceska Gynekol 2010; 75(3): 193-199

Overview

Objective:
To assess the immunohistochemical expression of p53, bcl-2, c-erbB-2, Ki-67, estrogen (ER) and progesterone (PR) receptors in endometrial cancer patients. To assess the relation between steroid receptors positivity and other markers. To evaluate the prognostic significance of clinicopathologic and immunohistochemical markers on patient disease free survival.

Design:
Experimental prospective study.

Setting:
Department of Obstetrics and Gynaecology, Institute of Human Genetics, Department of Pathology, Department of Biophysics, 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 and PR antigens were investigated with the use of an immunohistochemical method. In a group of 122 patients we assessed disease free survival (DFS) in relation to clinicopathologic and immunohistochemical factors.

Results:
From the total group of 144 patients, 122 were included for survival analysis. We found 15 (12,3%) patients with recurrence of the disease. Mean age was 64,5 (34-88) years. Immunohistologic expression was p53 positive in 29 (23,8%), bcl-2 positive in 87 (71,3%), c-erbB-2 positive in 34 (27,9%), Ki-67 positive in 56 (45,9%), ER positive in 97 (79,5%) and PR positive in 106 (86,9%) of cases.

In the survival analysis significantly shorter DFS was present in tumours with poor differentiation (G3), deep myometrial invasion (M2) and positive lymphoinvasion (N).

Conclusion:
Only poor differentiation (G3) and deep myometrial invasion (M2) are significant independent factors for the length of DFS.

Key words:
endometrial cancer, immunohistochemistry, prognostic factor, recurrence.

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