Abstract
Objective. To analyze clinico-pathological features of Chinese patients with UPSC, and investigate roles of Her-2/neu protein expression and gene amplification in UPSC prognosis. Methods. Thirty-six patients with UPSC treated in Cancer Hospital of Fudan University from 1996 to 2006 were analysed retrospectively. Chromogenic in situ hybridization (CISH) and immunohistochemistry (IHC) were performed to evaluate Her-2/neu gene amplification and protein expression respectively. Results. The median age was 63 years, and 61% (22/36) were late stages (stage III/IV). The 1-year, 3-year, and 5-year overall survival (OS) was 73.1%, 51.9% and 43.9%, respectively. Advanced stages (P = .0006) and deep myometrial invasion (P = .0138) were significantly associtated with a shorter OS. In 36 cases, 27.8% (10/36) showed 2+ staining and 8.3% (3/36) showed 3+ by IHC. Amplification of the Her-2/neu gene was observed in 11.1% (4/36) cases. The 5-year overall survival rate in Her-2/neu IHC 2 + ∼3+ and 0 ~ 1+ cases was 12.9% and 68.6% respectively. Her-2/neu protein expression 2 + ∼3+ was significantly associated with advanced surgical stage and worse overall survival (P = .03 and P = .0023, resp.). Conclusion. Chinese patients with UPSC showed characteristics of deep myometrial invasion, advanced stages and poor overall survival. Her-2/neu protein overexpression is associated with advanced stage and poor survival outcome.
Highlights
Endometrial cancer is the fourth most common cancer among women in the United States
457 patients with endometrial cancer were treated in our hospital during the last 10 years and 36 cases of Uterine papillary serous carcinoma (UPSC) were rediagnosed, which accounted for about 8%
Amplification in high level (++)× 400 (c) Figure 1: (a) Hematoxylin and eosin stain and (b) immunohistochemical staining 3+ for Her-2/neu expression on paraffin-embedded uterine serous carcinoma specimens. ×200. (c) Her-2/neu gene amplification amplified in high level. ×400
Summary
Endometrial cancer is the fourth most common cancer among women in the United States. In Shanghai, China, the ageadjusted incidence of endometrial cancer increased by 4.41% per year between 1973 to 1975 and 1997 to 1999 [2,3,4]. Endometrial cancer has been divided into two subtypes (type I and II) based on different morphological appearance and clinicalpathological characteristics [5,6,7]. Type I, which is endometrioid histology with relatively low-grade features and good prognoses, occurs most often in postmenopausal women and is associated with unopposed estrogen exposure. Type II endometrial cancer comprises of nonendometrial histology with an aggressive clinical course and poor prognoses
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