دورية أكاديمية
Molecular markers and clinical behavior of uterine carcinosarcomas: focus on the epithelial tumor component.
| العنوان: | Molecular markers and clinical behavior of uterine carcinosarcomas: focus on the epithelial tumor component. |
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| المؤلفون: | de Jong RA; Department of Gynecologic Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. r.a.de.jong@og.umcg.nl, Nijman HW, Wijbrandi TF, Reyners AK, Boezen HM, Hollema H |
| المصدر: | Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc [Mod Pathol] 2011 Oct; Vol. 24 (10), pp. 1368-79. Date of Electronic Publication: 2011 May 13. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Inc Country of Publication: United States NLM ID: 8806605 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1530-0285 (Electronic) Linking ISSN: 08933952 NLM ISO Abbreviation: Mod Pathol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2023- : [New York] : Elsevier Inc. Original Publication: Baltimore, MD : Williams & Wilkins, c1988- |
| مواضيع طبية MeSH: | Biomarkers, Tumor/*analysis , Carcinosarcoma/*chemistry , Epithelial Cells/*chemistry , Uterine Neoplasms/*chemistry, Aged ; Carcinosarcoma/mortality ; Carcinosarcoma/pathology ; Chi-Square Distribution ; Epithelial Cells/pathology ; Female ; Humans ; Immunohistochemistry ; Kaplan-Meier Estimate ; Logistic Models ; Middle Aged ; Neoplasm Invasiveness ; Prognosis ; Risk Assessment ; Risk Factors ; Survival Rate ; Time Factors ; Tissue Array Analysis ; Uterine Neoplasms/mortality ; Uterine Neoplasms/pathology |
| مستخلص: | Carcinosarcomas (malignant mixed Müllerian tumors) of the uterus are rare and aggressive malignancies consisting of an epithelial (carcinoma) and a mesenchymal (sarcoma) tumor component and are considered as metaplastic endometrial carcinomas. This study evaluated molecular characteristics and clinical behavior of uterine carcinosarcomas to improve treatment regimens in the future. Immunohistochemical expression of estrogen receptor-α and -β, progesterone receptor-A and -B, MLH1, MSH2, MSH6, PTEN (phosphatase and tensin homolog deleted on chromosome 10), p53, β-catenin and cyclin D1 was determined in 40 uterine carcinosarcomas. Immunostaining was compared between epithelial and mesenchymal tumor components. To determine the prognostic role of the epithelial component, clinicopathological data and survival were compared between patients with endometrioid and non-endometrioid epithelial tumor components. To determine prognosis of carcinosarcomas compared with high-risk endometrial carcinomas, clinicopathological characteristics and survival were compared between these patients. Hormone receptor expression occurred infrequently: estrogen receptor-α (8%) and -β (32%), progesterone receptor-A (0%) and -B (23%), next to β-catenin (4%) and cyclin D1 (7%). PTEN, MLH1, MSH2 and MSH6 mutations occurred in 39%, 33%, 22% and 21%, respectively (based on absent immunostaining). Overexpression of p53 was observed in 38%. Expression patterns of p53, MSH2 and MSH6 corresponded between epithelial and mesenchymal tumor components. In our cohort, the epithelial component caused the majority of metastases (72%) and vascular invasion (70%). Survival tended to be worse for patients with a non-endometrioid epithelial component compared with an endometrioid epithelial component (5-year survival: 26% and 55%, respectively). Survival was worse for patients with uterine carcinosarcomas compared with high-risk endometrial carcinomas (grade 3 endometrioid and non-endometrioid); 5-year survival rates: 42%, 77% and 57%, respectively. Our results support the monoclonal origin of uterine carcinosarcomas. The epithelial component determines prognosis by causing the majority of metastases and vascular invasion. To improve prognosis, treatment should focus on the epithelial tumor component of uterine carcinosarcomas. |
| المشرفين على المادة: | 0 (Biomarkers, Tumor) |
| تواريخ الأحداث: | Date Created: 20110517 Date Completed: 20120207 Latest Revision: 20230210 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1038/modpathol.2011.88 |
| PMID: | 21572397 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1530-0285 |
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| DOI: | 10.1038/modpathol.2011.88 |