2021
DOI: 10.1002/cjp2.243
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Selection of endometrial carcinomas for p53 immunohistochemistry based on nuclear features

Abstract: The World Health Organization endorses molecular subclassification of endometrial endometrioid carcinomas (EECs). Our objectives were to test the sensitivity of tumor morphology in capturing p53 abnormal (p53abn) cases and to model the impact of p53abn on changes to ESGO/ESTRO/ESP (European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology) risk stratification. A total of 292 consecutive endometrial carcinoma resections received at Foothills Medical… Show more

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Cited by 22 publications
(45 citation statements)
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“…We only found one sample with changes in MMR proteins and none with altered p53. The latter appears in agreement with a recent paper which re-assed p53 staining in ∼200 endometrial cancers and reported abnormal staining in only 14.5% of stage 1A samples (Kang et al, 2022). A previous study identified HAND2 as a candidate for epigenetic deregulation in EC (Jones et al, 2013) although another study failed to find evidence of change that could distinguish hyperplasia with or without atypia (Buell-Gutbrod et al, 2015) they did think it might be a useful biomarker.…”
Section: Discussionsupporting
confidence: 93%
“…We only found one sample with changes in MMR proteins and none with altered p53. The latter appears in agreement with a recent paper which re-assed p53 staining in ∼200 endometrial cancers and reported abnormal staining in only 14.5% of stage 1A samples (Kang et al, 2022). A previous study identified HAND2 as a candidate for epigenetic deregulation in EC (Jones et al, 2013) although another study failed to find evidence of change that could distinguish hyperplasia with or without atypia (Buell-Gutbrod et al, 2015) they did think it might be a useful biomarker.…”
Section: Discussionsupporting
confidence: 93%
“…The phenotype–genotype correlation has its limitations when it comes to molecular subtyping within histotypes. Phenotypes can direct certain tests [ 105 ], but most tests need to be carried out in a phenotype-agnostic manner specific for a given histotype (under the condition that other histotypes are vigorously excluded). There are many possible approaches to molecular subtyping.…”
Section: Discussionmentioning
confidence: 99%
“…Data from a population-based outcome registry of 4546 EC patients diagnosed during an era with mostly sporadic ancillary testing (2008–2016) show the disease-specific 5-year survival for the 2063 women in the low-risk group (EEC1/2 at stage IA) is 98.5% 15 . There is not much room for further improvement, particularly if one considers that more women with this diagnosis die of other causes rather than their stage IA EEC1/2 as indicated by an overall survival of 95.5% 17 . The ESGO/ESTRO/ESP guidelines state “In low-risk ECs, the molecular classification may not be required.” 10 Why abandon histotype/grade classification when the standard classification works very effectively for at least half of all EC patients?…”
Section: Diagnostic Precisionmentioning
confidence: 99%
“…However, there are many ECs with bland nuclear features (open and vesicular chromatin), which cannot have a TP53 mutation accompanied by a copy-number-high status and therefore do not need to be tested. In a consecutive series of 292 EC cases, we asked 3 pathologists whether they would order p53 IHC based on p53abn-like nuclear features, and they did so in roughly half of the cases 17 . By doing so, they were able to identify the 14.5% of p53abn cases with a very high negative predictive value of 99.6% 17 .…”
Section: Oxymoron 1: the P53abn “Eec1/2”mentioning
confidence: 99%
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