Abstract
Endometrial cancer begins in the layer of cells that form the lining (endometrium) of the uterus. Endometrial cancer is often detected at an early stage because it frequently produces abnormal vaginal bleeding, which prompts women to see their doctors. If endometrial cancer is discovered early, removing the uterus surgically often cures endometrial cancer. The study included all patients who had been evaluated for vaginal bleeding in Obstetrics and Gynecology Department of Clinical Emergency County Hospital, Timisoara between 2016-2018. Of the 195 cases of uterus scraping, 19 cases were labelled as malignant endometrial pathology. For the statistical analysis we calculated some descriptive statistics for the age parameter and the BMI (body mass index) parameter in our disease sample and we compared the BMI values to the BMI values from the control sample As well, we tested to see if there is an association between the Ki-67 values and the HER-2 / neu status in patients with or without endometrial carcinoma. In order to test the significance we applied a Mann -Whitney test, for a = 0.05 set as a confidence level. Unfortunately, in the case of our study group, type 1 endometrial cancers are found in only 5 cases, unlike other countries where most of endometrial cancers are diagnosed early (80% in the first stage) and the 5-year survival rate is about 95%. In any case, the 5-year survival rate is much lower if there is involvement of regional lymph nodes or distant metastasis (68% and 17%, respectively) - as in our case where all cases were classified as Stage III and IV. By running the statistical test we obtained extremely significant differences in the BMI of our patients (p[0.001), the diseased patients tend to have higher BMI values. As well, when we tested the possible association between the Ki-67 values and the HER-2 / neu status in our two groups (patients with or without endometrial carcinoma) we obtained extremely significant differences (p[0.001). The Ki-67 values are increasing proportionally with the carcinoma staging. An endometrial biopsy is the most commonly used test for endometrial cancer and is very accurate in postmenopausal women.
Highlights
Endometrial cancer begins in the layer of cells that form the lining of the uterus
It is important that malignant endometrial pathology can be detected early and the lesions are limited to the uterus in 70% of the cases
In the case of our study group, type 1 endometrial cancers are found in only 5 cases, unlike other countries where most of endometrial cancers are diagnosed early (80% in the first stage) and the 5-year survival rate is about 95%
Summary
We studied HER-2/neu amplification status and Ki-67 expression in hysterectomy specimens of endometrial carcinoma, determined by immunohistochemical analysis correlated with some clinical and pathological factors. Among the markers of proliferation, our study suggested that Ki-67 provided additional information on clinical progression and prognosis. The study included all patients who had been evaluated for vaginal bleeding in Obstetrics and Gynecology Department of Clinical Emergency County Hospital, Timisoara between 2016-2018. The anatomopathological results consisted of 13 cases of endometrial adenocarcinoma, 3 cases of mixed carcinoma and 3 cases of clear-cell carcinoma. The statistical analysis was performed using two different programs: Microsoft Excel and SPSSv17. For the descriptive statistics we calculated the central tendency parameters and the dispersion parameters, we made frequency tables and we plotted the most important results.
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