Abstract
The majority of endometrial carcinomas are classified as Type I endometrioid endometrial carcinomas (EECs) and have a good prognosis. Type II non-endometrioid endometrial carcinomas (NEECs) have a significant worse outcome. Yet, 20 % of the EECs are associated with an unexplained poor outcome. The aim of this study was to determine if L1CAM expression, a recently reported biomarker for aggressive tumor behavior in endometrial carcinoma, was associated with clinicopathological features of EECs. A total of 103 patients diagnosed as EEC at the Radboud University Medical Centre, based on the pathology report were selected. L1CAM status of these tumors was determined, and histologic slides were reviewed by two expert pathologists. L1CAM-positivity was observed in 17 % (18/103). Review of the diagnostic slides revealed that 11 out of these 18 L1CAM-positive tumors (61 %) contained a serous- or mixed carcinoma component that was not initially mentioned in the pathology report. L1CAM-expression was associated with advanced age, poor tumor grade, and lymphovascular space invasion. A worse five year progression free survival rate was observed for patients with L1CAM-positive tumors (55.6 % for the L1CAM-positive group, compared to 83.3 % for the L1CAM-negative group P = 0.01). L1CAM expression carries prognostic value for histologically classified EEC and supports the identification of tumors with a NEEC component.Electronic supplementary materialThe online version of this article (doi:10.1007/s12253-016-0047-8) contains supplementary material, which is available to authorized users.
Highlights
Endometrial carcinoma is the most common gynecological malignancy in industrialized nations [1]
The majority of endometrial carcinomas is classified as type I endometrioid endometrial carcinoma (EEC) and has a good prognosis in general
Lymph node dissection was performed only in patients suspected of advanced stage and/non-endometrioid histology according the Dutch guideline for endometrial cancer treatment
Summary
Endometrial carcinoma is the most common gynecological malignancy in industrialized nations [1]. The majority of endometrial carcinomas is classified as type I endometrioid endometrial carcinoma (EEC) and has a good prognosis in general. Type II carcinoma represents non-endometrioid endometrial carcinoma (NEEC), and carries a high risk of disease progression. Type II carcinomas on the contrary, are often aneuploid, and show over expression of P53 and Her2/neu [2, 3]. About 20 % of the individual cases does not fit within this dualistic model: EECs with poor clinical outcome [3, 4]. This group of endometrial carcinomas are either misclassified based on their histological appearance, or are inherently different despite truly morphological and clinical characteristics of EEC
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