Nguyen Thuy Thi, Hachisuga Toru, Urabe Rie, Kurita Tomoko, Kagami Seiji, Kawagoe Toshinori, Shimajiri Shohei, Nabeshima Kazuki
Department of Obstetrics and Gynecology, School of Medicine, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan,
Virchows Arch. 2015 Jun;466(6):695-702. doi: 10.1007/s00428-015-1752-5. Epub 2015 Mar 19.
The p53 signature (p53S) has been proposed to be a marker of the earliest phase of development of endometrial serous carcinoma. We examined the presence of p53S in the background endometrium in cases of endometrial carcinoma. From a series of 351 endometrial carcinomas, 225 (64.1 %) lesions, for which slides of the adjacent noncancerous endometrium were available for review, were included. Expression of estrogen receptor (ER)-alpha, Ki-67, and p53 in the adjacent endometrium was studied by immunohistochemistry. The p53S was defined as the presence of morphologically benign endometrial epithelial cells with moderate to strong intensity of p53 immunostaining. Of the 225 noncancerous endometrium samples, 34 consisted of hyperplastic and 191 of non-hyperplastic endometrium. A p53S was found in 22 cases (mean age 64.2 years), 2 in hyperplastic, and 20 in non-hyperplastic background endometrium. All p53S-positive cases also expressed ER-alpha; their median Ki-67 labeling index (LI) was 4.0 % (range 0.0 to 21.0 %). The two cases with hyperplastic p53S-positive background endometrium were in association with a grade 1 endometrioid tumor in a premenopausal woman with Lynch syndrome. Of the 152 cases of endometrioid adenocarcinomas with non-hyperplastic endometrium, 12 (8 %) were p53S positive, none of which associated with EIC. Of the 21 cases of serous carcinoma, five (24 %) were p53S positive, 4 of which (19 %) associated with EIC while in 5 others (24 %) EIC was found without p53S. Of three clear cell adenocarcinomas, none were p53S positive while two contained EIC without p53S. Of 15 carcinosarcomas, 3 (20 %) were p53S positive, all of which with EIC while 6 others (40 %) were associated with EIC but without p53S. Of the 8 non-endometrioid tumors with p53S, 7 (88 %) were associated with EIC. p53S is thought to be associated with precancerous lesions of non-endometrioid tumors, including carcinosarcomas.
p53特征（p53S）已被提议作为子宫内膜浆液性癌最早发展阶段的一个标志物。我们检查了子宫内膜癌病例中背景子宫内膜中p53S的存在情况。在一系列351例子宫内膜癌中，纳入了225例（64.1%）病变，这些病变有相邻非癌性子宫内膜的切片可供复查。通过免疫组织化学研究了相邻子宫内膜中雌激素受体（ER）-α、Ki-67和p53的表达。p53S被定义为存在形态学上良性的子宫内膜上皮细胞，其p53免疫染色强度为中度至强阳性。在225例非癌性子宫内膜样本中，34例为增生性子宫内膜，191例为非增生性子宫内膜。在22例（平均年龄64.2岁）中发现了p53S，其中2例在增生性背景子宫内膜中，20例在非增生性背景子宫内膜中。所有p53S阳性病例也表达ER-α；它们的Ki-67中位标记指数（LI）为4.0%（范围0.0至21.0%）。2例增生性p53S阳性背景子宫内膜病例与一名患有林奇综合征的绝经前妇女的1级子宫内膜样肿瘤相关。在152例非增生性子宫内膜的子宫内膜样腺癌病例中，12例（8%）为p53S阳性，其中无一例与子宫内膜上皮内癌（EIC）相关。在21例浆液性癌病例中，5例（24%）为p53S阳性，其中4例（19%）与EIC相关，而在另外5例（24%）中发现有EIC但无p53S。在3例透明细胞腺癌中，无一例为p53S阳性，而2例含有无p53S的EIC。在15例癌肉瘤中，3例（20%）为p53S阳性，所有这些病例都有EIC，而另外6例（40%）与EIC相关但无p53S。在8例有p53S的非子宫内膜样肿瘤中，7例（88%）与EIC相关。p53S被认为与包括癌肉瘤在内的非子宫内膜样肿瘤的癌前病变有关。
