Abstract

Uterine serous papillary carcinoma (UPSC) is an aggressive tumor, often diagnosed as a metastatic disease and characterized by a high recurrence rate and poor prognosis. UPSC represents a distinct subtype of endometrial cancer which is different in clinical and pathological behaviors from endometrioid endometrial carcinoma (EEC) and resembles more to serous ovarian carcinoma. Since tumors of serous papillary of the ovary are hypothesized to stem from cells of the fallopian tube's fimbria, we hypothesized that UPSC may also origin in the fallopian tubes. In our previous study, using a novel method of computerized morphometry of the fimbrial epithelium we have found significant differences between fimbriae of healthy women and serous ovarian cancer patients. In this study we showed the presence of morphologic differences between twenty-four fimbriae from healthy women, and twenty six fimbriae from uterus cancer (13 from UPSC patients and 13 from EEC patients). All fimbriae reported by the pathologist as "normal" were subjected to a computerized histomorphometric analysis. Two-step method of computerized histomorphometry, i.e. Fast Fourier transformation (FFT) followed by a co-occurrence matrix analysis and an additional analysis of the nuclear symmetry of the tubal fimbrial epithelium were applied. Using these novel methods, we were able to show differences in the morphometric characteristics of the fimbriae in UPSC patients compared to EEC and healthy patients. It is yet to be determined the clinical significance of this observation.

Highlights

  • Endometrial cancer is the most common gynecology malignancy in the United States with 47,130 new cases and about 8010 deaths annually [1]

  • Significant differences in the morphometric variables were found between the fimbriae of the patients with uterine papillary serous carcinoma (UPSC) and the patients with endometrial carcinoma (EEC), as well as between each one of them and the group of healthy women

  • Two textural morphometric variables differed between the fimbriae from patients with EEC and patients with UPSC (Table 1: homogeneity: p = 0.001 and entropy: p = 0.002)

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Summary

Introduction

Endometrial cancer is the most common gynecology malignancy in the United States with 47,130 new cases and about 8010 deaths annually [1]. Endometrial tumors are categorized by histological appearance, epidemiology and clinical course [2]. There are two major types of uterine carcinomas. Endometrioid endometrial carcinoma (EEC) is usually of a low to moderately differentiated grade, comprising about 80% of malignancies in uterine cancer cases.

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