Relationship between mismatch repair protein expression and clinicopathological features of endometrial cancer

Abstract

Objective To screen out probable lynch syndrome (LS) associated endometrial cancer (EC) by investigating the expression of mismatch repair (MMR) protein in EC, and to analyze the disease traits combined with clinicopathologic characteristics. Methods The expressions of MSH2, MSH6, MLH1 and PMS2 were detected by using immunohistochemistry (IHC) in 443 EC patients. Results In 443 EC patients, 328 cases (74 %) with all MMR proteins expression were classified as sporadic EC, and 115 cases (26 %) cases with loss expression of at least one MMR protein were regarded as probable LS. MMR-deficient cases mostly showed a loss of MLH1/PMS2 expression (42 %), followed by the absence of MSH2/MSH6 (23 %), MSH6 (17 %), PMS2 (17 %) and MSH6/MLH1/PMS2 (3 %). Compared with the sporadic EC group, obesity was not found in probable LS group (body mass index 0.05). A higher tumor grade was more common in the MSH6 and PMS2 deficient groups. Conclusions Compared with sporadic EC, the absence of obesity, a high grade tumor are more common in probable LS cases. Key words: Endometrial neoplasms; Lynch syndrome; Immunohistochemistry; DNA mismatch repair