Markova I., Duskova M., Lubusky M., Kudela M., Zapletalova J., Prochazka M., Pilka R.Selected immunohistochemical prognostic factors in endometrial cancer. International Journal of Gynecological Cancer, 2010, 20 (4), p. 576-582. (2009 IF-2,179)
ABSTRACT
Objective: The objectives of this study were to assess the immunohistochemical expression of p53, bcl-2, c-erbB-2, Ki-67, estrogen (ER) and progesterone (PR) receptors, matrix
metalloproteinase-7 and -26 (MMP-7 and MMP-26) in endometrial cancer patients and 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, Palack] 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 among immunohistochemical staining and the age, International Federation of Gynecology and
Obstetrics stage, grading, depth of invasion, and metastatic spread to lymph nodes.
Results: Mean age was 65.7 years (range, 34Y90 years). p53, bcl-2, c-erbB-2, Ki-67, ER,
and 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. Matrix metalloproteinases were evaluated in a group of
70 patients, wherein MMP-7 was positive in 33 patients (47.1%) and MMP-26 was positive
in 40 patients (57.1%). The expression of MMP-7 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, whereas immunostaining
for c-erbB-2 correlated inversely with ER-positive group of cases.
Conclusions: The overexpression of p53 and Ki-67 seems to indicate a more malignant
phenotype, whereas bcl-2 expression in dependence of steroid receptor positivity could
contribute to the identification of high-risk tumors.
Key Words: Endometrial cancer, Immunohistochemistry, Prognostic factors