MICROSATELLITH INSTABILITY IN ENDOMETRIUM CARCINOMA: DETECTION WITH IMMUNOHISTOCHEMICAL MARKERS AND ITS RELATIONSHIP WITH CLINICAL METERS
Project no. 25217 · Status: Kapanmış (Yayın bekleniyor) · 2022
Summary
<p>ABSTRACT PURPOSE: The aim of our study is to reveal the molecular features of endometrial cancer by immunohistochemical (IHC) method and to determine their relationship with prognostic variables. MATERIAL AND METHOD: 100 primary endometrioid type endometrial carcinoma cases, surgically staged in Ege University Gynecological Oncology Department, were included in the study. The files of the patients who applied between 2002-2016 were searched. The IHC method was used to evaluate MMR deficiency. Tumor areas were isolated from formalin-fixed, paraffin-embedded tissue samples after identification by a pathologist on sections stained with hematoxylin and eosin. Tissues obtained from the appropriate paraffin blocks of the cases were stained as IHC using MLH1, MSH2, MSH6 and PMS2 markers. A tumor sample was defined as MMR deficiency (dMMR) with a loss of at least one of the MMR proteins. The cases were divided into two groups as microsatellite stable (MSS without MMR protein deficit) and non-microsatellite (MSI with loss of expression in any MMR protein). The cases were compared in terms of prognostic factors with loss of nuclear expression in MMR proteins by IHC method. In addition, the effects of these parameters on survival were examined. RESULTS: According to the FIGO 2009 staging system, the patients included in the study were distributed as Stage I patient group 77 (77%), stage II 14 (14%), stage III 8 (8%), stage IV 1 (1%). LVSI was detected in 36 (36%) patients and not observed in 64 (64%) patients. Twenty-eight (28%) of the cases were found to be grade 1, 57% grade 2, and 15% grade 3. The number of patients with cervical involvement was 82 (82%), and the number of patients without cervical involvement was 18 (18%). Adnexial involvement was detected in only 2 (2%) patients out of a hundred patients, and adnexal involvement was not observed in 98 (98%) patients. While the number of patients with deep myometrial invasion (DMI) was 39 (39%), DMI was not detected in 61 (61%) patients. While lymph node involvement was negative in 76 (76%) of 100 patients, involvement was found in 5 (5%) patients, but lymph node involvement was not evaluated in 19 patients. During the follow-up period, recurrence was found in 11 (11%) patients, and no recurrence was xiv found in 89 (89%) patients. Of the 100 patients, 71 (71%) were in the group with no loss of any MMR genes (MMR negative) and 29 (29%) were the group with at least 1 loss of MMR genes(MMR positive). The number of patients with MLH1 loss was 25 (25%), the number of patients with PMS2 loss was 25 (25%), the number of patients with MLH1/PMS2 loss was 25 (25%), the number of patients with MSH2 loss was 3 (3%), and the number of patients with MSH6 loss was 6 (6%), MSH6 and the number of patients with MSH2/MSH6 loss was 3 (3%). CONCLUSION: As a result of IHC evaluation in endometrioid type endometrial cancers, a significant relationship was found between MMR and lymphovascular space involvement and deep myometrial invasion. However, there was no effect on survival. Keywords: Endometrioid type endometrium cancer, dMMR, MS</p>