Journal of Pathology and Translational Medicine

Original Articles

Potential Role for a Panel of Immunohistochemical Markers in the Management of Endometrial Carcinoma: Amany Salama, Mohammad Arafa, Eman ElZahaf, Abdelhadi Mohamed Shebl, Azmy Abd El-Hameed Awad, Sylvia A. Ashamallah, Reda Hemida, Anas Gamal, Abd AlRahman Foda, Khaled Zalata, El-Said M. Abdel-Hady; J Pathol Transl Med. 2019;53(3):164-172. Published online February 28, 2019; DOI: https://doi.org/10.4132/jptm.2019.02.12

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Background
In order to improve the efficacy of endometrial carcinoma (EC) treatment, identifying prognostic factors for high risk patients is a high research priority. This study aimed to assess the relationships among the expression of estrogen receptors (ER), progesterone receptors (PR), human epidermal growth factor receptor 2 (HER2), Ki-67, and the different histopathological prognostic parameters in EC and to assess the value of these in the management of EC.
Methods
We examined 109 cases of EC. Immunohistochemistry for ER, PR, HER2, and Ki-67 were evaluated in relation to age, tumor size, International Federation of Gynecology and Obstetrics (FIGO) stage and grade, depth of infiltration, cervical and ovarian involvement, lymphovascular space invasion (LVSI), and lymph node (LN) metastasis.
Results
The mean age of patients in this study was 59.8 ± 8.2 years. Low ER and PR expression scores and high Ki-67 expression showed highly significant associations with non-endometrioid histology (p = .007, p < .001, and p < .001, respectively) and poor differentiation (p = .007, p < .001, and p <. 001, respectively). Low PR score showed a significant association with advanced stage (p = .009). Low ER score was highly associated with LVSI (p = .006), and low PR scores were associated significantly with LN metastasis (p = .026). HER2 expression was significantly related to advanced stages (p = .04), increased depth of infiltration (p = .02), LVSI (p = .017), ovarian involvement (p = .038), and LN metastasis (p = .038). There was a close relationship between HER2 expression and uterine cervical involvement (p = .009). Higher Ki-67 values were associated with LN involvement (p = .012).
Conclusions
The over-expression of HER2 and Ki-67 and low expression of ER and PR indicate a more malignant EC behavior. An immunohistochemical panel for the identification of high risk tumors can contribute significantly to prognostic assessments.

Citations

Citations to this article as recorded by

Estrogen/Progesterone Receptor Loss, CTNNB1 and KRAS Mutations Are Associated With Local Recurrence or Distant Metastasis in Low-Grade Endometrial Endometrioid Carcinoma
Rajni Chibbar, Sabrina Foerstner, Janarathnee Suresh, Richa Chibbar, Alexandre Piche, Deeksha Kundapur, Rani Kanthan, Vijayanand Kundapur, Cheng Han Lee, Anita Agrawal, Raymond Lai
Applied Immunohistochemistry & Molecular Morphology.2023; 31(3): 181. CrossRef
Exploring the Prognostic and Predictive Roles of Ki-67 in Endometrial Cancer
Laura Paleari, Mariangela Rutigliani, Oriana D’Ecclesiis, Sara Gandini, Irene Maria Briata, Tania Buttiron Webber, Nicoletta Provinciali, Andrea DeCensi
International Journal of Translational Medicine.2023; 3(4): 479. CrossRef
Correlation of PD-L1 immunohistochemical expression with microsatellite instability and p53 status in endometrial carcinoma
Mohammad Arafa, Abdelhadi Mohamed Shebl, Amany Salama, Eman ElZahaf, Sylvia A. Ashamallah, Abd AlRahman Foda, AzmyAbd El-Hameed Awad, Asem Shalaby
European Journal of Obstetrics & Gynecology and Reproductive Biology: X.2022; 16: 100172. CrossRef
Immunohistochemical Expression of Oestrogen and Epidermal Growth Factor Receptors in Endometrial Cancerous in Sudanese Patients
Salwa Abdalraheem Abubaker, Mohamed Elfatih Abdelwadoud, Mutaz Mohamed Ali, Hadia Alhaj Ahmad, Abuobieda Mohamed Khlafalla, Osman Mohammed Elmahi, Hisham Ali Waggiallah
Journal Of Biochemical Technology.2021; 12(1): 58. CrossRef
Expression of ER/PR Receptor, Her-2/neu, Ki67 and p53 in Endometrial Carcinoma: Clinicopathological Implication and Prognostic Value
V. B. Shivkumar, Manisha A. Atram, Nitin M. Gangane
Indian Journal of Gynecologic Oncology.2020;[Epub] CrossRef
Immunohistochemical study of ER, PR, p53 and Ki67 expression in patients with endometrial adenocarcinoma and atypical endometrial hyperplasia
Rachana Lakhe, Ravi M Swami, Preeti Doshi, Manjiri N Karandikar, Ravindra Nimbargi
IP Archives of Cytology and Histopathology Research.2020; 5(4): 274. CrossRef

Morphological Features and Immunohistochemical Expression of p57Kip2 in Early Molar Pregnancies and Their Relations to the Progression to Persistent Trophoblastic Disease: Marwa Khashaba, Mohammad Arafa, Eman Elsalkh, Reda Hemida, Wagiha Kandil; J Pathol Transl Med. 2017;51(4):381-387. Published online June 12, 2017; DOI: https://doi.org/10.4132/jptm.2017.04.28

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Abstract PDF

Background
Although the morphological features characteristic of products of conception specimens including molar pregnancies are well described, substantial histopathological similarities are observed between the different entities, especially in cases of early pregnancies. Furthermore, there are no current solid criteria that could predict cases with progression to persistent gestational trophoblastic disease. In this study, we aimed to determine the most specific histopathological and immunohistochemical features required for accurate diagnosis that can reliably predict the clinical behavior.
Methods
Sixty-five cases of products of conception were reviewed clinically and pathologically, and any progression to persistent gestational trophoblastic disease (GTD), if present, was noted. Pathological assessment of the archival material included re-cut sections of 5 μm in thickness, routine staining with hematoxylin and eosin and immunohistochemical staining of p57Kip2.
Results
Certain histopathological criteria were found to be significant in differentiation between complete hydatidiform mole (CHM) and partial hydatidiform mole including villous shape and outline, villous trophoblast hyperplasia, and atypia in extravillous trophoblasts. There were no significant differences in any morphological or immunohistochemical features between cases with or without subsequent development of GTD.
Conclusions
Histopathological diagnosis of molar pregnancy remains problematic especially in early gestation. Their diagnosis should be stated after a constellation of specific histopathological criteria in order not to miss CHM. p57Kip2 immunohistochemistry is of great value in diagnosis of cases that had equivocal morphology by histopathological examination. However, there were no significant features to predict cases that subsequently developed persistent GTD.

Citations

Citations to this article as recorded by

Immunohistochemical expression of BCL-2 in hydatidiform moles: a tissue microarray study
Muna Al-Jabri, Suaad Al-Badi, Hunaina Al-Kindi, Mohammad Arafa
Pathologica.2023; 115(3): 148. CrossRef
Persistent gestational trophoblastic disease following ectopic molar pregnancy
I.N. Voloshchuk, I.V. Barinova, S.N. Buyanova, S.A. Petrakova, N.A. Shchukina, M.V. Mgeliashvili
Arkhiv patologii.2021; 83(1): 44. CrossRef
P57 and Ki-67 expression in hydropic abortion and molar pregnancy
Sylvia A. Ashamallah, Mie A. Mohamed, Hany O. Habashy
Egyptian Journal of Pathology.2017; 37(2): 393. CrossRef

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