Arciuolo Damiano, Travaglino Antonio, Santoro Angela, Scaglione Giulia, D'Alessandris Nicoletta, Valente Michele, Inzani Frediano, Accarino Rossella, Piermattei Alessia, Benvenuto Roberta, Raffone Antonio, Nero Camilla, Pelligra Silvia, Fanfani Francesco, Mascolo Massimo, Zannoni Gian Franco
Pathology Unit, Department of Woman and Child's Health and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.
Department of Life Health and Public Health, Catholic University of the Sacred Hearth, 00168 Rome, Italy.
Cancers (Basel). 2022 Jul 26;14(15):3635. doi: 10.3390/cancers14153635.
In endometrial carcinoma, both L1CAM overexpression and microcystic, elongated and fragmented (MELF) patterns of invasion have been related to epithelial-to-mesenchymal transition and metastatic spread. We aimed to assess the association between L1CAM expression, the MELF pattern, and lymph node status in endometrial carcinoma. Consecutive cases of endometrial carcinoma with MELF pattern were immunohistochemically assessed for L1CAM. Inclusion criteria were endometrioid-type, low-grade, stage T1, and known lymph node status. Uni- and multivariate logistic regression were used to assess the association of L1CAM expression with lymph node status. Fifty-eight cases were included. Most cases showed deep myometrial invasion (n = 42, 72.4%) and substantial lymphovascular space invasion (n = 34, 58.6%). All cases were p53-wild-type; 17 (29.3%) were mismatch repair-deficient. Twenty cases (34.5%) had positive nodes. No cases showed L1CAM positivity in ≥10% of the whole tumor. MELF glands expressed L1CAM at least focally in 38 cases (65.5%). L1CAM positivity in ≥10% of the MELF component was found in 24 cases (41.4%) and was the only significant predictor of lymph node involvement in both univariate (p < 0.001) and multivariate analysis (p < 0.001). In conclusion, L1CAM might be involved in the development of the MELF pattern. In uterine-confined, low-grade endometrioid carcinomas, L1CAM overexpression in MELF glands may predict lymph node involvement.
在子宫内膜癌中，L1细胞粘附分子（L1CAM）的过表达以及微囊状、细长且碎片化（MELF）的浸润模式均与上皮-间质转化及转移扩散相关。我们旨在评估L1CAM表达、MELF模式与子宫内膜癌淋巴结状态之间的关联。对连续的具有MELF模式的子宫内膜癌病例进行L1CAM的免疫组织化学评估。纳入标准为子宫内膜样型、低级别、T1期且已知淋巴结状态。采用单因素和多因素逻辑回归分析来评估L1CAM表达与淋巴结状态的关联。共纳入58例病例。大多数病例显示有深肌层浸润（n = 42，72.4%）和大量淋巴管间隙浸润（n = 34，58.6%）。所有病例均为p53野生型；17例（29.3%）为错配修复缺陷型。20例（34.5%）有阳性淋巴结。无病例在整个肿瘤的≥10%区域显示L1CAM阳性。38例（65.5%）的MELF腺体至少局灶性表达L1CAM。24例（41.4%）在MELF成分的≥10%区域发现L1CAM阳性，且在单因素分析（p < 0.001）和多因素分析（p < 0.001）中，它是淋巴结受累的唯一显著预测因子。总之，L1CAM可能参与了MELF模式的形成。在局限于子宫的低级别子宫内膜样癌中，MELF腺体中L1CAM的过表达可能预示着淋巴结受累。
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