High-grade Endometrioid Carcinoma of the Ovary

Abstract

Although infrequently encountered, the diagnosis of ovarian high-grade endometrioid carcinoma remains a diagnostic challenge with potential consequences for targeted therapies and genetic counselling. We studied the clinical, morphologic, and immunohistochemical features of ovarian high-grade endometrioid carcinomas and their diagnostic reproducibility compared with tuboovarian high-grade serous carcinomas. Thirty cases confirmed as International Federation of Gynecology and Obstetrics grade 3 endometrioid carcinomas were identified from 182 ovarian endometrioid carcinomas diagnosed in Alberta, Canada, between 1978 and 2010, from the population-based Alberta Ovarian Tumor Types cohort. Cases of lower grade endometrioid and high-grade serous carcinoma served for comparison. Ten immunohistochemical markers were assessed on tissue microarrays. Clinical data were abstracted and survival analyses performed using Cox regression. Interobserver reproducibility for histologic type was assessed using 1 representative hematoxylin and eosin-stained slide from 25 randomly selected grade 3 endometrioid carcinomas and 25 high-grade serous carcinomas. Histotype was independently assigned by 5 pathologists initially blinded to immunohistochemical WT1/p53 status, with subsequent reassessment unblinded to WT1/p53 status. Patients diagnosed with grade 3 endometrioid carcinoma had a significantly longer survival compared with high-grade serous carcinoma in univariate analysis (hazard ratio [HR]=0.34, 95% confidence interval [CI]=0.16-0.67, P=0.0012) but not after adjusting for age, stage, treatment center, and residual tumor (HR=1.01, 95% CI=0.43-2.16, P=0.98). Grade 3 endometrioid carcinoma cases (N=30) were identical to grade 2 endometrioid carcinoma cases (N=23) with respect to survival in univariate analysis (HR=1.07, 95% CI=0.39-3.21, P=0.89) and immunohistochemical profile. Using histomorphology alone, interobserver agreement for the diagnosis of grade 3 endometrioid or high-grade serous carcinoma was 69%, which significantly increased (P<0.0001) to 96% agreement with the knowledge of WT1/p53 status. Our data support the diagnostic value of WT1/p53 status in differentiating between grade 3 endometrioid carcinoma and high-grade serous carcinoma. However, grade 3 and grade 2 endometrioid carcinomas showed no differences in immunophenotype or clinical parameters, suggesting that they could be combined into a single group.

MicroRNA-149 suppresses the proliferation and increases the sensitivity of ovarian cancer cells to cisplatin by targeting X-linked inhibitor of apoptosis

“…Patients were between 25 and 85 years of age, with a mean age of 44.5±3.4. According to the criteria of the International Federation of Gynecology and Obstetrics, International Gynecologic Cancer Society (14), these patients were divided into three stages (stage I, n=12; stage II, n=28; stage III, n=18). The exclusion criteria of samples are as follows: i) Patients who were pregnant when they were afflicted with ovarian cancer, ii) patients who were simultaneously afflicted with ovarian cancer and other malignant tumor types and iii) patients whose case or data were incomplete.…”

Molecular stratification of endometrioid ovarian carcinoma predicts clinical outcome

“…WT1 IHC is a useful tool to discriminate high grade EnOC (WT1 negative) from HGSOC (WT1 positive), reducing interobserver variation 16,20,[24][25][26][27] . Here, we perform molecular characterisation of contemporarily defined EnOC with the use of IHC for WT1.…”

Ovarian Cancer: Diagnostic accuracy and tumor types distribution in East Africa compared to North America

“…Hormonal receptor expression in EC was also lower compared to the previous studies (40,41), and this could probably be attributed to weak staining or biological behavior of the EC, which cannot be justi ed. Low hormonal receptor expression is common in high grade EC (42), but, in this study, tumor grades were equally distributed across all EC cases. Interestingly, we observed only one case (3%) (41-year-old patient with endometrioid carcinoma) that showed abnormal mismatch repair, contrary to 13%, as reported previously (43).…”