Abstract
PurposeAlteration of CyclinD1 was suggested to relate with development of endometrial carcinogenesis before, however CyclinD1 expression is not well defined in endometrial hyperplasia lesions. We checked the relationship between its expression and clinic-pathological variables of endometrial lesions to explore the possibility for CyclinD1 as a potential diagnostic and prognostic marker.MethodsCyclin D1 immunohistochemical analysis (IHC) was used to evaluate 201 fixed, paraffin-embedded endometrial samples which included simple hyperplasia (n = 27), atypical complex hyperplasia (ACH) (n = 41), endometrioid carcinoma (n = 103), endometrial serous carcinoma (ESC) (n = 21) and clear cell carcinoma (CCC) (n = 9). A breast cancer with known CyclinD1 expression was selected as a positive control in each immunohistochemistry run. We also performed follow-up study to estimate patients’ prognosis.ResultsCyclinD1 was significantly overexpressed in atypical complex hyperplasia (ACH), endometrioid carcinoma and clear cell carcinoma (CCC). The positive signaling of CyclinD1 was showed less than 40% in simple hyperplasia and endometrial serous carcinoma (ESC). The high expression of CyclinD1 was observed in metastasis carcinoma group more significantly than non-metastasis carcinoma group. Kaplan Meier analysis demonstrated that patients with high CyclinD1 expression had an obviously poor prognosis than patients without CyclinD1 staining (p < 0.05). Moreover, according to multivariate Cox regression analysis, CyclinD1 expression, as crucial as metastasis, was a risk marker for overall survival rate.ConclusionCyclinD1 exhibited a promising potential to predict the prognosis of patients with endometrial carcinoma. However, the statistical analysis demonstrated that CyclinD1 exhibited a poor ability to differentiate neoplastic lesions from non-neoplastic lesions; thus, the application of CyclinD1 only is not so credible for differentiation between benign and malignant lesions.Virtual slidesThe virtual slides for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1871063048950173.
Highlights
Endometrial cancer is the most common malignancy of the female genital tract in the world and the seventh most common cause of death for women in Western Europe who suffer from cancer
We investigated the expression of CyclinD1 in 5 different pathological types of endometrial diseases, including simple hyperplasia, atypical complex hyperplasia, endometrioid carcinoma, endometrial serous carcinoma and clear cell carcinoma, by immunohistochemistry
Endometrioid carcinoma and clear cell carcinoma showed more positive staining compared with simple hyperplasia and endometrial serous carcinoma, the p value was larger than 0.005 after comparing CyclinD1 expression in five endometrial lesions with each other respectively
Summary
Endometrial cancer is the most common malignancy of the female genital tract in the world and the seventh most common cause of death for women in Western Europe who suffer from cancer. Even though the routine evaluation of estrogen receptor (ER), CyclinD1 ( known as BCL1) which is best known for its utility in mantle cell lymphoma diagnosis is encoded by the CCND1 gene in human beings [2,3,4]. As a cell -cycle regulator, CyclinD1 is essential for progression through G1 phase and is a candidate proto-oncogene [5]. *: Grade and score by the intensity of immunoreactivity staining: 0 point for absent, 1 point for weak, 2 points for moderate and 3 points for strong; grade by the extent of tissue staining: 0 point for no positive staining cells, 1 point for positive ratio 3 points for positive
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