Immunohistochemical evaluation and lymph node metastasis in surgically staged endometrial carcinoma

To assess the expression of immunohistochemical markers in surgically staged endometrial cancer patients.

We studied 107 cases of primary untreated endometrial carcinoma in which the p53, bcl-2, her-2/neu, Ki-67, estrogen receptor (ER) and progesterone receptor (PR) antigens were investigated by an immunohistochemical method. In the last 50 consecutive patients immunoreactivity for MMP-7 and MMP-26 was assessed as well. We evaluated the correlations among the immunohistochemical staining assessed by histoscore, and the age, grading, depth of invasion, stage of the neoplasia and extrauterine disease.

Mean age was 65 years (range 34-88). All patients were submitted to total abdominal or modified radical vaginal hysterectomy plus bilateral salpingo-oophorectomy and systematic pelvic lymphadenectomy; p53, bcl-2, her-2/neu, Ki-67, MMP-7, MMP-26, estrogen and progesterone receptors were positive in 36 (43%), 71 (86%), 13 (16%), 80 (96%), 65 (78%), 80 (96%), 61 (73%) and 71 (86%) patients, respectively. p53 overexpression was found to be related to poor grade of differentiation and deep myometrial invasion. Immunostaining for ER was inversely related to the histopathological differentiation of the tumors. Decreased expression of PR was related to advanced stage, poor histopathologic differentiation and extrauterine spread of disease.

The overexpression of p53 seems to indicate more malignant phenotype, while PR expression correlates with parameters of better clinical outcome.