Low grade endometrial endometrioid adenocarcinoma: A review and update with emphasis on morphologic variants, mimics, immunohistochemical and molecular features

Lucas, Elena; Carrick, Kelley

doi:10.1053/j.semdp.2022.02.002

Cited by 10 publications

(5 citation statements)

References 107 publications

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“…Most corpus uteri cancers are adenocarcinomas, with endometrioid cancer being the most common type. 29 This finding was confirmed by our research. In the current study, adenocarcinoma of the uterus accounted for approximately 53% of all uterine cancers.…”

Section: Discussionsupporting

confidence: 88%

Uterine and Cervical Cancer in Iran: An epidemiologic analysis of the Iranian National Population-Based Cancer Registry

AziziKia,

Didar,

Teymourzadeh

et al. 2023

Arch Iran Med

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Background: Gynecologic cancers, including neoplasms of the cervix and uterine, are the fourth most common malignancies, causing 3.46% of deaths in women aged 15 to 59. Objectives: We aimed to report the Iranian National Population-based Cancer Registry (INPCR) results for Cervical and Uterine cancers in 2017. Methods: The total population of Iran in 2017 was 80881792. INPCR collected data on cervical and uterine cancer incidence from 31 provinces of Iran. In this project, we retrospectively examined all the country’s regions in terms of screening for the existence of these two cancers. The registry data bank in Iran was used. Results: Overall, 3481 new cervical and uterine cancer cases were registered in INPCR, including 842 cases of cervical cancer (with a crude rate of 1.04) and 2639 cases of uterine cancer (with a crude rate of 3.26). The average age-standardized incidence rate (ASR) was 0.99 for cervical cancer and 3.29 for uterine cancer. Out of 3481 new cervical and uterine cancer cases, 2887 were registered with pathological findings and 594 without pathological confirmation. In cervical cancers, the highest rate was related to squamous cell carcinoma, with 486 cases (57.72%). Conclusion: Our results showed that Iran is a low-risk area for the incidence of cervical and uterine cancers. In this study, the highest rate of cervical cancer was related to squamous cell carcinoma, confirming previous reports. However, this rate was lower than previous studies and suggested an increase in other types of cervical cancer in Iran.

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Section: Discussionsupporting

confidence: 88%

Uterine and Cervical Cancer in Iran: An epidemiologic analysis of the Iranian National Population-Based Cancer Registry

AziziKia,

Didar,

Teymourzadeh

et al. 2023

Arch Iran Med

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“…In the original study by Regner et al. ( 20 ), all five EC patients were diagnosed as EAC, which accounts for approximately 80% of endometrial epithelial malignancies ( 25 ). The patients 3 had the highest proportion of cancer cells, and the patients 1 had the lowest proportion, showing an inter-tumoral heterogeneity in EC.…”

Section: Discussionmentioning

confidence: 99%

Integrating single-cell RNA-seq and spatial transcriptomics reveals MDK-NCL dependent immunosuppressive environment in endometrial carcinoma

Xie

et al. 2023

Front. Immunol.

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ObjectivesThe tumor microenvironment (TME) play important roles in progression of endometrial carcinoma (EC). We aimed to assess the cell populations in TME of EC.MethodsWe downloaded datasets of single-cell RNA-seq (scRNA-seq) and spatial transcriptome (ST) for EC from GEO, and downloaded RNA-Seq (FPKM) and clinical data of TCGA-UCEC project from TCGA. The datasets were analyzed using R software.ResultsWe obtained 5 datasets of scRNA-seq, 1 of ST and 569 samples of RNA-seq. Totally, 0.2 billion transcripts and 33,408 genes were detected in 33,162 cells from scRNA-seq. The cells were classified into 9 clusters, and EC cells were originated from epithelial cells and ciliated cells. Gene set variation analysis (GSVA) indicated that the pathways enriched in the subclusters of epithelial cells and endothelial cells were significantly different, indicating great heterogeneity in EC. Cell-cell communication analyses showed that EC cells emitted the strongest signals, and endothelial cells received more signals than other cells. Further analysis found that subclusters of 1 and 2 of epithelial cells were showed a more malignant phenotype, which may confer malignant phenotype to subcluster of 0 of endothelial cells through MK pathway by MDL-NCL signal. We also analyzed communications between spatial neighbors with ST data and confirmed the findings on MDL-NCL in cell-cell communication. TCGA and GEO analyses indicated that the expression levels of NCL was inversely correlated with ImmuneScore.ConclusionOur study revealed EC cells can confer malignant phenotype to endothelial cells by MDK-NCL signal, and NCL is associated with suppressed immune activity. EC cells may shape TME by inhibiting immune cells and “educating” stromal cells via MDK-NCL signal.

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“…In addition to glandular proliferation, endometrial cancers exhibit cellular features, such as mucin production, squamous metaplasia (morula) or obvious keratinization, clear cell changes, bizarre GTCs, and inflammatory cell infiltration into the cancer stroma and tumor nests (8,15,16). Endometrial cancers exhibit serous morphology, in which papillary growth generates a micropapillary pattern with hierarchical branching and condensation, leading to the formation of solid nests; this is diagnostic of serous carcinoma (4,17,18).…”

Section: Discussionmentioning

confidence: 99%

Cervical Cytology Preserves Histologically Detected Surface Epithelial Slackening, Unique to thePOLEMutation-subtype in Endometrial Cancer

KITAZONO,

AKAHANE,

YOKOYAMA

et al. 2023

In Vivo

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Background/Aim: Among the four genomic subtypes of endometrial cancer, distinguishing between the DNA polymerase epsilon mutation (POLEmut) and no specific molecular profile (NSMP) subtypes requires genomic profiling owing to the lack of surrogate immunohistochemical markers. We have previously found that, histologically, the POLEmut-subtype exhibits surface epithelial slackening (SES). Therefore, to improve subtype identification, we aimed to extract cytological features corresponding to SES in POLEmut-subtype cervical cytology specimens. Materials and Methods: We analyzed 104 endometrial cancer cervical cytology specimens, with integrative diagnosis confirmation via histology, immunohistochemistry, and genomic profiling. Cytological features were evaluated for the presence of atypical glandular cells, atypical cell appearance in single cells and clusters, and cytological SES and the presence of tumor-infiltrating inflammatory cells in clusters. Results: Based on cervical cytology, the POLEmut-and p53mutsubtypes exhibited more frequent atypical cells in smaller clusters, giant tumor cells, and cytological SES patterns than the NSMP-subtype. Tumor-infiltrating lymphocytes were frequent in the POLEmut-and mismatch repair-deficient subtypes. Conclusion: Histologically-detected SES as well as other endometrial cancer features may be preserved in the atypical cell clusters observed in cervical cytology specimens. Cytological detection of SES and of smaller clusters of atypical cells and inflammatory cells with moderate atypia are suggestive of POLEmut-subtype. Integrative diagnosis including genomic profiling remains critical for diagnostic confirmation.Comprehensive examination of cancer gene alterations is useful for cancer subtype classification, molecularly targeted drug selection, and prognostic speculation (1-3). The Cancer Genome Atlas (TCGA)-based integrative genomic classification system for endometrial tumors, which is introduced in the latest WHO classification of female genital tract tumors (4), includes four subtypes: mismatch repair (MMR)-deficient (MMRd), p53 mutation (p53mut), DNA polymerase epsilon (POLE) mutation (POLEmut), and no specific molecular profile (NSMP). These categories, which correspond well with prognosis, are helpful in managing patient care in endometrial cancer (5).MMR and p53 expression provide surrogate markers for diagnosing the MMRd-and p53mut-subtypes, respectively (4, 6). In contrast, because there is no specific antibody for 321

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Low grade endometrial endometrioid adenocarcinoma: A review and update with emphasis on morphologic variants, mimics, immunohistochemical and molecular features

Cited by 10 publications

References 107 publications

Uterine and Cervical Cancer in Iran: An epidemiologic analysis of the Iranian National Population-Based Cancer Registry

Uterine and Cervical Cancer in Iran: An epidemiologic analysis of the Iranian National Population-Based Cancer Registry

Integrating single-cell RNA-seq and spatial transcriptomics reveals MDK-NCL dependent immunosuppressive environment in endometrial carcinoma

Cervical Cytology Preserves Histologically Detected Surface Epithelial Slackening, Unique to thePOLEMutation-subtype in Endometrial Cancer

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