Department of Gynecology, Vilnius University Hospital "Santaros Klinikos", 08406 Vilnius, Lithuania.
Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania.
Int J Mol Sci. 2024 Aug 21;25(16):9084. doi: 10.3390/ijms25169084.
Few studies have evaluated cytokeratin's (CK) staining patterns in atypical endometrial hyperplasia (AEH) coexisting with early-stage endometrial cancer (EC). We aimed to assess the staining patterns of selected CKs (CK7, CK19, CK20, CK AE1/AE3) in 74 patients with coexisting AEH and EC by independently analyzing both morphological variables. Specimens were collected from women with AEH and EC who underwent surgical interventions between 2012 and 2019 at the Department of Obstetrics and Gynecology of Vilnius University Hospital "Santaros Klinikos" in Vilnius, Lithuania. Immunostaining was also qualitatively classified as being heterogeneous or intense. The results revealed heterogeneous CK7 expression in all AEH cases and intense staining in 95.95% cases of AEH. The heterogeneous expression of CK7 was detected in all EC specimens. Intense CK7 expression was observed in 95.09% cases of EC G1 and in all G2 ECs. Heterogenous CK19 expression was present in all AEH specimens with intense staining in 92.42% of cases. Heterogeneous CK19 expression was observed in all EC samples with intense expression in 86.27% cases of EC G1 and 100% cases of EC G2. Interestingly, a significant relationship was found when comparing the heterogeneous expression of CK19 between AEH and well-differentiated EC. A significant difference was reported in the intense expression of CK AE1/AE3 ( = 0.031; = 0.029) between AEH and G2 ECs and in the intense expression of CK AE1/AE3 between G1 and G2 ECs. CK20 staining was not a characteristic feature for AEH and early-stage EC. CK staining is present either in AEH or in early-stage endometrioid-subtype EC in different manners. Heterogeneous CK19 expression was significantly more common in AEH than in EC. CK20 expression was not associated with either AEH nor early-stage EC. An intense expression of CK AE1/AE3 was mainly present in moderately differentiated ECs, whereas the intense reactivity of AE1/AE3 showed a significant difference in well to moderately differentiated uterine tumors. The clinical implication of CK staining may aid in the more accurate diagnosis of AEH and early-stage EC as well as detect micrometastases leading to better oncological outcomes.
很少有研究评估在伴有早期子宫内膜癌的不典型子宫内膜增生（AEH）中细胞角蛋白（CK）染色模式。我们旨在通过独立分析形态学变量，评估 74 例 AEH 伴 EC 患者中选定 CK（CK7、CK19、CK20、CK AE1/AE3）的染色模式。标本来自于 2012 年至 2019 年期间在立陶宛维尔纽斯大学桑塔罗斯克林基奥医院妇产科接受手术干预的 AEH 和 EC 女性。免疫染色也被定性为异质性或强烈。结果显示，所有 AEH 病例均有 CK7 表达异质性，95.95%的 AEH 病例有强烈染色。所有 EC 标本均检测到 CK7 异质性表达。95.09%的 EC G1 和所有 G2 EC 中均观察到 CK7 强烈表达。所有 AEH 标本均有 CK19 异质性表达，92.42%的病例有强烈染色。所有 EC 标本均观察到 CK19 异质性表达，86.27%的 EC G1 和 100%的 EC G2 病例有强烈表达。有趣的是，当比较 AEH 和分化良好的 EC 之间 CK19 的异质性表达时，发现了显著的关系。AEH 和 G2 EC 之间 CK AE1/AE3 的强烈表达（=0.031；=0.029）以及 G1 和 G2 EC 之间 CK AE1/AE3 的强烈表达存在显著差异。CK20 染色不是 AEH 和早期子宫内膜样亚型 EC 的特征。CK 染色以不同的方式存在于 AEH 或早期子宫内膜样亚型 EC 中。AEH 中 CK19 异质性表达明显比 EC 更常见。CK20 表达与 AEH 或早期 EC 均无关。CK AE1/AE3 的强烈表达主要存在于中度分化的 EC 中，而 AE1/AE3 的强烈反应在分化良好到中度的子宫肿瘤中显示出显著差异。CK 染色的临床意义可能有助于更准确地诊断 AEH 和早期 EC，并检测微转移，从而获得更好的肿瘤学结果。
