High-mobility group AT-hook 2 expression in serous and endometrioid endometrial carcinomas: Diagnostic value and relation to clinicopathological parameters

Abstract

Background Subtyping of endometrial carcinoma, mainly high-grade cases, is a major pathological dilemma. Several biomarkers have been evaluated for differentiation between serous endometrial carcinoma (SEC) and endometrioid endometrial carcinoma (EEC), with variable sensitivity and specificity. Aim To evaluate the diagnostic role of high-mobility group AT-hook 2 (HMGA-2) in differentiation between SEC and EEC, compared with p16 and progesterone receptor (PR), and to evaluate HMGA-2 expression in endometrial carcinoma in relation to clinicopathological parameters. Materials and methods This study included 62 endometrial carcinoma specimens, classified as 20 biopsies of serous carcinoma and 42 endometrioid carcinomas. All specimens were subjected to immunohistochemistry using HMGA-2, p16, and PR antibodies. Results HMGA-2, p16, and PR showed significantly different expression between serous and endometrioid carcinomas. P16 showed more sensitivity and specificity (85 and 80.9%, respectively) than HMGA-2 (75 and 71.4%, respectively) in diagnosis of SEC. PR showed sensitivity and specificity of 88.1 and 90%, respectively, in diagnosis of EEC. Moreover, high HMGA-2 expression was significantly related to high tumor grade, advanced tumor stage, and presence of lymphovascular invasion. Conclusions HMGA-2 can be used as an adjunct biomarker in diagnosis of SEC, combined with p16 and PR. Moreover, HMGA-2 can be considered as a marker of aggressive tumor behavior in endometrial carcinoma.