Journal of Pathology and Translational Medicine

Original Article

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

Tissue Microarray for Gynecological Pathology Studies: A Mini-Review
Mohammad Arafa, Abd AlRahman Foda, Amany Salama, Ola Shalaby, Muna Al-Jabri, Fatma Al Hinai, Afrah Al-Rashdi, Samya Al-Husaini, Suaad Al-Badi
Journal of Microscopy and Ultrastructure.2026;[Epub] CrossRef
Clinicopathological Correlation of Hormone Receptors, Angiogenesis, and Tumor Budding in Endometrial Carcinoma: A Tertiary Care Center Study
Senjuti Dasgupta, Arpita Das, Ujjwal Bandyopadhyay
The Journal of Obstetrics and Gynecology of India.2025;[Epub] CrossRef
Multiparameter MRI-based radiomics analysis for preoperative prediction of type II endometrial cancer
Yingying Cao, Wei Zhang, Xiaorong Wang, Xiaojing Lv, Yaping Zhang, Kai Guo, Shuai Ren, Yuan Li, Zhongqiu Wang, Jingya Chen
Heliyon.2024; 10(12): e32940. CrossRef
Correlation of PD-L1 expression with different clinico-pathological and immunohistochemical features of ovarian surface epithelial tumors
Asem Shalaby, Ola Shalaby, Hazem Abdullah, Mohamed Rachid Boulassel, Mohammad Arafa
Clinical and Translational Oncology.2024; 27(2): 699. CrossRef
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
Analysis of human epidermal growth factor receptor 2 immunohistochemical expression in high-grade endometrial carcinomas and its association with variable clinical outcomes
Malames M. Faisal, Marwa M. Shakweer, Ghada Refaat, Khaled S. Mohammed, Tarek I. ElMallawy, Magda H. Nasreldin, Laila M. Farid, Mariam B. Abouelkhair
Egyptian Journal of Pathology.2023; 43(2): 119. 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
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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
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Review

Galectins: Double-edged Swords in the Cross-roads of Pregnancy Complications and Female Reproductive Tract Inflammation and Neoplasia: Nandor Gabor Than, Roberto Romero, Andrea Balogh, Eva Karpati, Salvatore Andrea Mastrolia, Orna Staretz-Chacham, Sinuhe Hahn, Offer Erez, Zoltan Papp, Chong Jai Kim; J Pathol Transl Med. 2015;49(3):181-208. Published online May 15, 2015; DOI: https://doi.org/10.4132/jptm.2015.02.25

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Abstract PDF

Galectins are an evolutionarily ancient and widely expressed family of lectins that have unique glycan-binding characteristics. They are pleiotropic regulators of key biological processes, such as cell growth, proliferation, differentiation, apoptosis, signal transduction, and pre-mRNA splicing, as well as homo- and heterotypic cell-cell and cell-extracellular matrix interactions. Galectins are also pivotal in immune responses since they regulate host-pathogen interactions, innate and adaptive immune responses, acute and chronic inflammation, and immune tolerance. Some galectins are also central to the regulation of angiogenesis, cell migration and invasion. Expression and functional data provide convincing evidence that, due to these functions, galectins play key roles in shared and unique pathways of normal embryonic and placental development as well as oncodevelopmental processes in tumorigenesis. Therefore, galectins may sometimes act as double-edged swords since they have beneficial but also harmful effects for the organism. Recent advances facilitate the use of galectins as biomarkers in obstetrical syndromes and in various malignancies, and their therapeutic applications are also under investigation. This review provides a general overview of galectins and a focused review of this lectin subfamily in the context of inflammation, infection and tumors of the female reproductive tract as well as in normal pregnancies and those complicated by the great obstetrical syndromes.

Citations

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Case Reports

Angioleiomyoma of the Nasal Cavity: A Case Report.: Su Jin Kim, Sook Hee Hong, Mee Sook Roh; Korean J Pathol. 2004;38(3):181-183.

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Abstract PDF: Angioleiomyoma of the sinonasal area is an extremely rare benign neoplasm. To the best of our knowledge, only 26 cases have been described. Here, we report a case of angioleiomyoma arising in the nasal cavity of a 60-year-old woman. Microscopically, the tumor consisted of proliferating smooth muscle cells punctuated with thick-walled vessels with slit-like lumina. The tumor was negative for estrogen and progesterone receptor by immunohistochemical study. Further studies are needed to clarify whether the growth of this tumor is sex steroid-dependent.

Diffuse Leiomyomatosis of the Uterus: A Brief Case Report.: Su Jin Kim, Mee Sook Roh; Korean J Pathol. 2005;39(1):63-65.

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Abstract PDF: Diffuse leiomyomatosis of the uterus is a rare condition that is distinguished from the uterine leiomyoma due to the diffuse involvement of the myometrium by numerous, ill-defined, smooth muscle nodules. We present here a case of diffuse uterine leiomyomatosis in a 34-year-old woman. The hysterectomy revealed a symmetrically enlarged uterus containing numerous, small, ill-defined leiomyomatous nodules. Microscopically, the nodules were composed of compact fascicles and interweaving bundles of uniform benign smooth muscle cells. On the immunohistochemical staining, the progesterone receptor level was higher in the leiomyomatosis than in the adjacent normal myometrial tissue, but the estrogen receptor level and Ki-67 labeling index were equal in both areas. At the twelve months follow-up, this patient has been doing very well with no evidence of pelvic or intraabdominal recurrence of disease.

Original Article

Adrenal Pseudocyst as a Result of Longterm Intake of Steroid Hormone.: Woo Sung Moon, So Yeong Oh, Myoung Jae Kang, Dong Geun Lee, Ho Yeul Choi, Sang Ho Kim; Korean J Pathol. 1996;30(4):355-357.

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Abstract PDF: Adrenal pseudocysts are uncommon lesions which usually occur as a result of hemorrhage within the adrenal tissue. Adrenal hemorrhage is usually associated with severe stress, sepsis, pregnancy, syphilis, leukemia, or anticoagulant therapy but during steroid therapy, it is very rare. We report a case of adrenal pseudocyst that resulted from hemorrhage into the adrenal gland and is probably related to the exogenous administration of steroids. The patient was a 57-year-old woman who was treated with oradexon for 20 years for the treatment of a maculopapular lesion on her thigh as well as for arthritis. She underwent a right adrenalectomy due to the adrenal cystic mass. The wall of the cystic mass was composed of a thick layer of hyalinized fibrous tissue with remnants of adrenal cortical tissue on the outer aspect. The inner surface had no lining cells and the wall of the cyst contained many calcified plaques with hemosiderin pigment.

Case Report

Systemic Nocardiosis: An autopsy case.: Eun Sun Park, Kyo Young Lee, Sang In Shim, Sun Moo Kim; Korean J Pathol. 1988;22(2):131-137.

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Abstract PDF: Nocardia species are aerobic, gram-positive, acid-fast, filamentous branching bacilli. Nocardia is a localized or disseminated infection which may involve all tisuses and is produced by members of the genus Nocardia, principally N. asteroides. Other species, notably N. brasiliensis and N. caviae have been implicated, but N. asteroides appears to be the overwhelming predominant pathogen. Nocardial infections are usually opportunistic in the compromised host, at least 15% of the infections occurred in patients without a definable predisposing condition. Recently, we experienced an autopsy case of systemic nocardiosis. The patients was fiffty-three days old female infant, who had suffered from productive cough, dyspnea and fever. The patient was treated under the impression of the miliary tuberculosis, but she died at 34th hosital day. The postmortem examination reveals multiple tan gray colored abscess involving both lungs, both kidneys, and thymus. Microscopically, lung, kidney and thymus reveal multiple abscess, which are composed of necrotic tissue debris admixed with infiltrates of neutrophils, and they are surrounded by fibrosis, ad acute and chronic inflammatory cells. By histologic, microbiologic and biochemical studies, N. asteroides is identified in the lesion of the lung, kidney, thymus, and bronchial washing specimen.

Original Article

A Histologic Classification of Diffuse Interstitial Lung Disease and Its Clinical Significance.: Eun Suk Koh, Dong Wha Lee, So Young Jin, Sang Ho Cho; Korean J Pathol. 1996;30(11):998-1010.

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Abstract PDF: Diffuse interstitial lung disease(DILD) is a large group of heterogeneous diseases that diffusely involve the pulmonary connective tissues, principally subpleural, interlobular and alveolar wall portions. Terminology and classification of these diseases are not uniform, and the cause and the pathogenesis are unknown in many entities. It is generally accepted that the response to therapy is related to the relative degree of cellularity and fibrosis present, therefore a histologic evaluation of the relative extent and severity of these changes is required. We reviewed 52 cases of DILD from January 1990 to May 1995 diagnosed by open lung biopsy to reappraise classification and quantitative assessment of the histopathologic features. Differential histopathologic features between usual interstitial pneumonia(UIP) and nonspecific interstitial pneumonia(NIP) were examined with a correlation of HRCT findings and clinical findings. Among 52 cases of DILD, 18 cases(34.6%) were UIP, 6 cases(11.5%) were hypersensitivity pneumonia was NIP was 5 cases(9.6%), interstitial lung diseases associated with the connective tissue diseases were 5 cases(9.6%), inorganic dusts were 4 cases(7.7%), infections were 4 cases(7.7%), durgs were 2 cases(3.8%), acute interstitial pneumonia was 1 case(1.9%), sarcoidosis was 1 case(1.9%) in order of frequency plus 6 other cases(11.5%). UIP was the most frequent DILD in this study which seemed to be a criteria bias of patient selection on open lung biopsy. Quantitative assessment of histopathologic features was useful in the differential diagnosis of DILD and differentiation of UIP from NIP was possible based on histopathologic features and supported by HRCT. UIP disclosed a significantly high score of fibrotic changes, especially in the interstitial fibrosis, smooth muscle proliferation and honeycombing, otherwise NIP appeared relatively high score in inflammatory changes. Correlation between histopathologic scores and the clinical outcome after steroid therapy or no therapy in UIP was not evident.

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