Expression of ER/PR Receptor, Her-2/neu, Ki67 and p53 in Endometrial Carcinoma: Clinicopathological Implication and Prog
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ORIGINAL ARTICLE
Expression of ER/PR Receptor, Her-2/neu, Ki67 and p53 in Endometrial Carcinoma: Clinicopathological Implication and Prognostic Value V. B. Shivkumar1
•
Manisha A. Atram1
•
Nitin M. Gangane2
Received: 31 May 2020 / Revised: 9 July 2020 / Accepted: 25 July 2020 Ó Association of Gynecologic Oncologists of India 2020
Abstract Background Endometrial carcinoma (EC) is the second most common gynecological malignancy in developing world with a mortality rate of 1.7/100,000. This study aimed to determine association of expression of ER/PR, Her-2/neu, Ki67 and p53 with clinicopathological features and survival outcome in patients with endometrial carcinoma. Materials and Methods This was a retrospective study of 124 histologically confirmed cases with EC treated at our institute. The blocks of cases were retrieved from 2010 to 2015. The study period was from January 2017 to December 2019. Data on patient’s clinical details, histopathological diagnosis, treatment and follow-up were retrieved from hospital information system and pathology records. Immunohistochemical evaluation of ER/PR, Her-2/neu, Ki67 and p53 was done. Disease-free survival and overall survival of each category were analyzed by the Kaplan–Meier method. Results Type I EC was more common and accounted for 87.09% cases. The statistically significant clinicopathological parameters affecting disease-free survival and overall survival were age (p = 0.039), histological types (p = 0.007), tumor grade (p \ 0.001) and advanced FIGO stage (p \ 0.001). ER/PR-positive tumors were associated with better clinical outcome. Her-2/neu expression was more in type II EC (p = 0.001), with lymph node metastasis (p = 0.018). Overexpression of p53 is one of the hallmarks of type II EC. Conclusion ER/PR expression is a good prognostic marker, while overexpression of Her-2/neu, p53 and Ki67 indices of[/ = 35% was associated with more aggressive behavior and poor survival outcome in EC cases. Keywords Endometrial cancer ER/PR expression Her-2/neu status p53 Ki67
Introduction Endometrial cancer (EC) is the most common gynecological malignancy in developed countries [1]. According to the GLOBOCAN 2018 cancer statistics, there were 382,069 estimated new cases and 89,929 deaths attributed to EC worldwide [2]. The incidence and mortality rates of EC differ throughout the world; the rates are highest in North America and Western Europe, whereas they are lowest in South Asia and most of Africa [1]. However, the & Manisha A. Atram [email protected] 1
Department of Pathology, Mahatma Gandhi Institute of Medical Sciences (MGIMS), Sewagram, Wardha, Maharashtra 442102, India
2
Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra 442102, India
incidence of endometrial cancer has increased over the last few years, which is in part related to an increase in incidence of obesity, diabetes mellitus, infertility, menstrual disturbances, hormone replacement therapy, etc., which are strongly linked to a risk of endometrial carcinoma [3].
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