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Uterine papillary serous adenocarcinoma. A 10-case study of p53 and c-erbB-2 expression and DNA content
1Department of Pathology, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Spain.
Background:
Uterine papillary serous adenocarcinoma (UPSA) is a highly aggressive neoplasm with a great tendency for dissemination. p53 and c-erbB-2 immunoreactivity and DNA ploidy are considered to be indicators of prognosis for endometrial carcinomas.
Methods:
Ten cases of patients with UPSA are reported. An attempt to relate pathologic findings with immunohistochemical stains for p53- and c-erbB-2-associated proteins, ploidy, and survival was made.
Results:
Three patients were classified as having Stage I; three, Stage II; two, Stage III; and two, Stage IV. Myometrial invasion was present with nine tumors and involved over 50% of the myometrial thickness in five. Uterine lymph vessel invasion was detected in seven cases. Peritoneal spread occurred in six patients. Overexpression of p53 was observed in six tumors, immunoreactivity for c-erbB-2 in four, and aneuploidy in seven. However, only peritoneal spread correlated significantly with survival (P < 0.005).
Conclusions:
UPSA is a tumor with a high metastatic potential that exhibits immunoreactivity for p53 and c-erbB-2 and aneuploidy more often than that reported for conventional endometrioid adenocarcinomas.
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