Park Ji Y, Hong Daegy, Park Ji Young
Department of Pathology, School of Medicine, Catholic University of Daegu, Daegu, South Korea.
Department of Pathology, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, 807 Hoguk-ro, Buk-gu, Daegu, 41404, South Korea.
Pathol Oncol Res. 2019 Jan;25(1):123-130. doi: 10.1007/s12253-017-0320-5. Epub 2017 Oct 8.
In endometrial endometrioid adenocarcinoma (EEC), the depth of myometrial invasion (MI) is an important parameter for determining whether additional treatment is warranted. The present study investigated the association between MI patterns, cancer stem cell (CSC) phenotypes, and their clinicopathological significance in EEC. A total of 73 cases of EEC with MI were examined in this study. Haematoxylin and eosin-stained tissue specimens were analysed for MI pattern, which was categorised as infiltrating; expansile; adenomyosis (AM)-like; or microcystic, elongated, and fragmented (MELF)-type. The expression of CSC markers such as cluster of differentiation (CD)44, CD133, and Nanog1, as well as oestrogen receptor (ER) and progesterone receptor (PR) was examined by immunohistochemistry. Clinicopathological features including age, DOI, MI pattern, LVI, lymph node (LN) metastasis, disease progression, and survival outcome were recorded. Most examined cases (45/73) were International Federation of Gynecology and Obstetrics (FIGO) stage I. MI showed infiltrating (49.3%), AM-like (26.3%), MELF (15.1%), and expansile (9.6%) patterns. Tumours with the infiltrating pattern were associated with high FIGO grade (P = 0.002), reduced ER and PR, and CD44 expression (P = 0.014, 0.026, and 0.030, respectively); those with a MELF pattern showed LN metastasis (P < 0.001), lymphovascular invasion (P = 0.011), and reduced ER, CD44, and CD133 expression (P = 0.036, 0.006, and 0.016, respectively). EEC with infiltrating/MELF patterns of MI is associated with worse prognosis. These results suggest that CSC expression profiles are an unfavourable indicator of EEC.
在子宫内膜样腺癌（EEC）中，肌层浸润深度（MI）是决定是否需要额外治疗的重要参数。本研究调查了EEC中MI模式、癌症干细胞（CSC）表型及其临床病理意义之间的关联。本研究共检查了73例有MI的EEC病例。对苏木精和伊红染色的组织标本进行MI模式分析，分为浸润型、膨胀型、子宫腺肌病（AM）样型或微囊型、细长型和破碎型（MELF）型。通过免疫组织化学检测CSC标志物如分化簇（CD）44、CD133和Nanog1以及雌激素受体（ER）和孕激素受体（PR）的表达。记录临床病理特征，包括年龄、浸润深度、MI模式、淋巴血管浸润、淋巴结（LN）转移、疾病进展和生存结果。大多数检查病例（45/73）为国际妇产科联盟（FIGO）I期。MI表现为浸润型（49.3%）、AM样型（26.3%）、MELF型（15.1%）和膨胀型（9.6%）。浸润型肿瘤与高FIGO分级相关（P = 0.002），ER、PR和CD44表达降低（分别为P = 0.014、0.026和0.030）；MELF型肿瘤表现为LN转移（P < 0.001）、淋巴血管浸润（P = 0.011）以及ER、CD44和CD133表达降低（分别为P = 0.036、0.006和0.016）。具有浸润/MELF型MI的EEC预后较差。这些结果表明CSC表达谱是EEC的不良指标。
