Youssef Mona Y, Mohamed Mie A
Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Int J Gynecol Pathol. 2019 Mar;38(2):128-137. doi: 10.1097/PGP.0000000000000492.
Endometrial carcinoma contributes to morbidity and mortality among female individuals worldwide. The role of E-cadherin expression, as an adhesion molecule, in endometrial carcinoma is controversial. Moreover, the role of CD10-expressing stromal cells in endometrial carcinoma is still unclear. The aim of this work was to evaluate E-cadherin and CD10 expression in normal endometrium, atypical endometrial hyperplasia, and endometrial carcinoma, and assess their role to differentiate atypical endometrial hyperplasia from endometrial carcinoma. The association of E-cadherin and CD10 expression with clinicopathologic parameters of endometrial carcinoma was also determined. This retrospective study was carried out on 80 cases including 36 cases of endometrial adenocarcinoma (all were of endometrioid type), 34 cases of atypical endometrial hyperplasia, and another 10 cases of normal endometrial tissue. Immunohistochemistry for E-cadherin and CD10 was conducted. The studied patients were in their sixth and seventh decades of life with a mean age of 60.97 yr. Most of the carcinoma cases (18 cases) were grade 1, 10 cases were grade 2, and only 2 cases were grade 3. With regard to International Federation of Gynecology and Obstetrics (FIGO) staging, 28 cases were stage I, and only 2 cases were stage II. E-cadherin in normal endometrial tissue and atypical hyperplastic endometrial tissue showed predominantly membranous homogenous reactivity, and CD10 was detected as membranocyptoplasmic staining. However, we noticed the subcellular change of E-cadherin reactivity to be heterogenous and predominantly membranocytoplasmic in endometrial carcinoma, whereas CD10 remained membranocytoplasmic. Concerning E-cadherin expression, there was a statistically significant relationship between E-cadherin expression, tumor grade and FIGO staging, whereas there was an insignificant relationship between E-cadherin expression and patients' age, specimen type, tumor gross pattern, and histopathologic types. With regard to CD10 expression, there was a statistically significant relation between CD10 expression and tumor grade and FIGO staging with insignificant relation with patients' age, tumor gross pattern, specimen type, and tumor histologic types (villoglandular vs. usual endometrial adenocarcinoma). There was also a highly statistically significant positive relationship between E-cadherin expression and CD10 expression. This study puts the spot light on their role in differentiating between atypical endometrial hyperplasia and endometrial carcinoma, which is often difficult.
子宫内膜癌是全球女性发病和死亡的原因之一。E-钙黏蛋白作为一种黏附分子，其在子宫内膜癌中的作用存在争议。此外，表达CD10的基质细胞在子宫内膜癌中的作用仍不明确。本研究旨在评估E-钙黏蛋白和CD10在正常子宫内膜、非典型子宫内膜增生及子宫内膜癌中的表达情况，并评估它们在鉴别非典型子宫内膜增生与子宫内膜癌中的作用。同时，还确定了E-钙黏蛋白和CD10表达与子宫内膜癌临床病理参数之间的关联。本回顾性研究共纳入80例患者，其中包括36例子宫内膜腺癌（均为子宫内膜样型）、34例非典型子宫内膜增生以及另外10例正常子宫内膜组织。对E-钙黏蛋白和CD10进行了免疫组织化学检测。研究对象年龄多在六七十岁，平均年龄为60.97岁。大多数癌病例（18例）为1级，10例为2级，仅2例为3级。国际妇产科联盟（FIGO）分期方面，28例为I期，仅2例为II期。正常子宫内膜组织和非典型增生子宫内膜组织中的E-钙黏蛋白主要表现为膜性均匀反应，CD10检测为膜细胞质染色。然而，我们注意到在子宫内膜癌中，E-钙黏蛋白反应的亚细胞变化是异质性的，且主要为膜细胞质反应，而CD10仍为膜细胞质反应。关于E-钙黏蛋白表达，E-钙黏蛋白表达与肿瘤分级和FIGO分期之间存在统计学显著关系，而E-钙黏蛋白表达与患者年龄、标本类型、肿瘤大体形态及组织病理学类型之间无显著关系。关于CD10表达，CD10表达与肿瘤分级和FIGO分期之间存在统计学显著关系，与患者年龄、肿瘤大体形态、标本类型及肿瘤组织学类型（绒毛腺型与普通子宫内膜腺癌）之间无显著关系。E-钙黏蛋白表达与CD-10表达之间还存在高度统计学显著的正相关关系。本研究突出了它们在鉴别常常难以区分的非典型子宫内膜增生和子宫内膜癌中的作用。
