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Solanki R, Zubbair Malik M, Alankar B, Ahmad FJ, Dohare R, Chauhan R, Kesharwani P, Kaur H. Identification of novel biomarkers and potential molecular targets for uterine cancer using network-based approach. Pathol Res Pract 2024; 260:155431. [PMID: 39029376 DOI: 10.1016/j.prp.2024.155431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 06/20/2024] [Accepted: 06/26/2024] [Indexed: 07/21/2024]
Abstract
A better understanding of incidences at the cellular level in uterine cancer is necessary for its effective treatment and favourable prognosis. Till date, it lacks appropriate molecular target-based treatment because of unknown molecular mechanisms that proceed to cancer and no drug has shown the required results of treatment with less severe side effects. Uterine Cancer is one of the top five cancer diagnoses and among the ten most common death-causing cancer in the United States of America. There is no FDA-approved drug for it yet. Therefore, it became necessary to identify the molecular targets for molecular targeted therapy of this widely prevalent cancer type. For this study, we used a network-based approach to the list of the deregulated (both up and down-regulated) genes taking adjacent p-Value ≤ 0.05 as significance cut off for the mRNA data of uterine cancer. We constructed the protein-protein interaction (PPI) network and analyzed the degree, closeness, and betweenness centrality-like topological properties of the PPI network. Then we traced the top 30 genes listed from each topological property to find the key regulators involved in the endometrial cancer (ECa) network. We then detected the communities and sub-communities from the PPI network using the Cytoscape network analyzer and Louvain modularity optimization method. A set of 26 (TOP2A, CENPE, RAD51, BUB1, BUB1B, KIF2C, KIF23, KIF11, KIF20A, ASPM, AURKA, AURKB, PLK1, CDC20, CDKN2A, EZH2, CCNA2, CCNB1, CDK1, FGF2, PRKCA, PGR, CAMK2A, HPGDS, and CDCA8) genes were found to be key genes of ECa regulatory network altered in disease state and might be playing the regulatory role in complex ECa network. Our study suggests that among these genes, KIF11 and H PGDS appeared to be novel key genes identified in our research. We also identified these key genes interactions with miRNAs.
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Affiliation(s)
- Rubi Solanki
- School of Interdisciplinary Sciences and Technology, Jamia Hamdard, New Delhi 110062, India
| | - Md Zubbair Malik
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute Dasman 15462, Kuwait
| | - Bhavya Alankar
- Department of Computer Science and Engineering, School of Engineering Sciences and Technology, Jamia Hamdard, New Delhi 110062, India.
| | - Farhan Jalees Ahmad
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India
| | - Ravins Dohare
- Centre for Interdisciplinary Research in Basic Sciences, Faculty of Natural Sciences, Jamia Millia Islamia, New Delhi 110025, India
| | - Ritu Chauhan
- Artificial Intelligence and IoT lab, Centre for Computational Biology and Bioinformatics, Amity University, Noida, India
| | - Prashant Kesharwani
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India.
| | - Harleen Kaur
- Department of Computer Science and Engineering, School of Engineering Sciences and Technology, Jamia Hamdard, New Delhi 110062, India.
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Ma Y, Zhang Y, Wang Z, Li J, Miao Y, Yang F, Pan W. DSFF-GAN: A novel stain transfer network for generating immunohistochemical image of endometrial cancer. Comput Biol Med 2024; 170:108046. [PMID: 38325211 DOI: 10.1016/j.compbiomed.2024.108046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/31/2023] [Accepted: 01/26/2024] [Indexed: 02/09/2024]
Abstract
Immunohistochemistry (IHC) is a commonly used histological examination technique. Compared to Hematoxylin and Eosin (H&E) staining, it enables the examination of protein expression and localization in tissues, which is valuable for cancer treatment and prognosis assessment, such as the detection and diagnosis of endometrial cancer. However, IHC involves multiple staining steps, is time-consuming and expensive. One potential solution is to utilize deep learning networks to generate corresponding virtual IHC images from H&E images. However, the similarity of the IHC image generated by the existing methods needs to be further improved. In this work, we propose a novel dual-scale feature fusion (DSFF) generative adversarial network named DSFF-GAN, which comprises a cycle structure-color similarity loss, and DSFF block to constrain the model's training process and enhance its stain transfer capability. In addition, our method incorporates labeling information of positive cell regions as prior knowledge into the network to further improve the evaluation metrics. We train and test our model using endometrial cancer and publicly available breast cancer IHC datasets, and compare it with state-of-the-art methods. Compared to previous methods, our model demonstrates significant improvements in most evaluation metrics on both datasets. The research results show that our method further improves the quality of image generation and has potential value for the future clinical application of virtual IHC images.
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Affiliation(s)
- Yihao Ma
- School of Biology & Engineering (School of Modern Industry for Health and Medicine), Guizhou Medical University, Guiyang, Guizhou Province, China
| | - Yiqiong Zhang
- Guizhou Prenatal Diagnostic Center, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province, China; School of Clinical Laboratory Science, Guizhou Medical University, Guiyang, Guizhou Province, China
| | - Zhengrong Wang
- Guizhou Prenatal Diagnostic Center, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province, China
| | - Juan Li
- Department of Pathology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province, China
| | - Yuehong Miao
- School of Biology & Engineering (School of Modern Industry for Health and Medicine), Guizhou Medical University, Guiyang, Guizhou Province, China
| | - Fan Yang
- School of Biology & Engineering (School of Modern Industry for Health and Medicine), Guizhou Medical University, Guiyang, Guizhou Province, China.
| | - Wei Pan
- Guizhou Prenatal Diagnostic Center, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province, China; School of Clinical Laboratory Science, Guizhou Medical University, Guiyang, Guizhou Province, China.
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Vargas-Castro R, García-Becerra R, Díaz L, Avila E, Ordaz-Rosado D, Bernadez-Vallejo SV, Cano-Colín S, Camacho J, Larrea F, García-Quiroz J. Enhancing Tamoxifen Therapy with α-Mangostin: Synergistic Antiproliferative Effects on Breast Cancer Cells and Potential Reduced Endometrial Impact. Pharmaceuticals (Basel) 2023; 16:1576. [PMID: 38004441 PMCID: PMC10675669 DOI: 10.3390/ph16111576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023] Open
Abstract
Breast cancer is the most prevalent neoplasia among women worldwide. For the estrogen receptor-positive (ER+) phenotype, tamoxifen is the standard hormonal therapy; however, it carries the risk of promoting endometrial carcinoma. Hence, we aimed to evaluate the antiproliferative effect of the phytochemical α-mangostin (AM) as a co-adjuvant alongside tamoxifen on breast cancer cells to improve its efficacy while reducing its adverse effects on endometrium. For this, ER+ breast cancer cells (MCF-7 and T-47D) and endometrial cells (N30) were treated with AM, 4-hydroxytamoxifen (4-OH-TMX), and their combination. Cell proliferation was evaluated using sulforhodamine B assay, and the pharmacological interaction was determined through the combination index and the dose reduction index calculation. The genes KCNH1, CCDN1, MKI67, and BIRC5 were amplified by real-time PCR as indicators of oncogenesis, cell cycle progression, cell proliferation, and apoptosis, respectively. Additionally, genes involved in ER signaling were analyzed. In breast cancer cells, the combination of AM with 4-OH-TMX showed a synergistic antiproliferative effect and favorable dose reduction. AM and 4-OH-TMX decreased KCNH1, CCND1, and BIRC5 gene expression. In endometrial cells, AM decreased MKI-67 gene expression, while it reverted the 4-OH-TMX-dependent CCND1 upregulation. This study establishes the benefits of incorporating AM as a co-adjuvant for first-line ER+ breast cancer therapy.
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Affiliation(s)
- Rafael Vargas-Castro
- Departamento de Biología de la Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de Mexico 14080, Mexico; (R.V.-C.); (L.D.); (E.A.); (D.O.-R.); (S.V.B.-V.); (F.L.)
| | - Rocío García-Becerra
- Departamento de Biología Molecular y Biotecnología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de Mexico 04510, Mexico; (R.G.-B.); (S.C.-C.)
- Programa de Investigación de Cáncer de Mama, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de Mexico 04510, Mexico
| | - Lorenza Díaz
- Departamento de Biología de la Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de Mexico 14080, Mexico; (R.V.-C.); (L.D.); (E.A.); (D.O.-R.); (S.V.B.-V.); (F.L.)
| | - Euclides Avila
- Departamento de Biología de la Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de Mexico 14080, Mexico; (R.V.-C.); (L.D.); (E.A.); (D.O.-R.); (S.V.B.-V.); (F.L.)
| | - David Ordaz-Rosado
- Departamento de Biología de la Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de Mexico 14080, Mexico; (R.V.-C.); (L.D.); (E.A.); (D.O.-R.); (S.V.B.-V.); (F.L.)
| | - Samantha V. Bernadez-Vallejo
- Departamento de Biología de la Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de Mexico 14080, Mexico; (R.V.-C.); (L.D.); (E.A.); (D.O.-R.); (S.V.B.-V.); (F.L.)
| | - Saúl Cano-Colín
- Departamento de Biología Molecular y Biotecnología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de Mexico 04510, Mexico; (R.G.-B.); (S.C.-C.)
| | - Javier Camacho
- Departamento de Farmacología, Centro de Investigación y de Estudios Avanzados del I.P.N., Ciudad de Mexico 07360, Mexico;
| | - Fernando Larrea
- Departamento de Biología de la Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de Mexico 14080, Mexico; (R.V.-C.); (L.D.); (E.A.); (D.O.-R.); (S.V.B.-V.); (F.L.)
| | - Janice García-Quiroz
- Departamento de Biología de la Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de Mexico 14080, Mexico; (R.V.-C.); (L.D.); (E.A.); (D.O.-R.); (S.V.B.-V.); (F.L.)
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Grushko TA, Filiaci VL, Montag AG, Apushkin M, Gomez MJ, Monovich L, Ramirez NC, Schwab C, Kesterson JP, Seward SM, Method MW, Olopade OI, Fleming GF, Birrer MJ. Effects of Slide Storage on Detection of Molecular Markers by IHC and FISH in Endometrial Cancer Tissues From a Clinical Trial: An NRG Oncology/GOG Pilot Study. Appl Immunohistochem Mol Morphol 2022; 30:27-35. [PMID: 34224438 PMCID: PMC8664981 DOI: 10.1097/pai.0000000000000949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 04/13/2021] [Indexed: 01/03/2023]
Abstract
We performed a pilot study in anticipation of using long-aged precut formalin-fixed paraffin-embedded tissue sections stored in real-world conditions for translational biomarker studies of topoisomerase 2A (TOP2A), Ki67, and human epidermal growth factor receptor 2 (HER2) in endometrial cancer. Formalin-fixed paraffin-embedded tissue blocks or unstained slides or both from GOG-0177 were collected centrally (1999-2000) and stored at room temperature. During 2004 to 2011 specimens were stored at 4°C. Matched pairs of stored slides and freshly cut slides from stored blocks were analyzed for TOP2A (KiS1), Ki67 (MIB1), and HER2 (HercepTest) proteins. To assess DNA stability (HER2 PathVision), fluorescence in situ hybridization (FISH) was repeated on stored slides from 21 cases previously shown to be HER2 amplified. Immunohistochemistry (IHC) staining intensity and extent, mean FISH copies/cell, and copy number ratios were compared using the κ statistic for concordance or signed rank test for differences in old cut versus new cut slides. IHC results reflected some protein degradation in stored slides. The proportion of cells with TOP2A staining was lower on average by 12% in older sections (P=0.03). The proportion of Ki67-positive cells was lower in stored slides by an average of 10% (P<0.01). Too few cases in the IHC cohort were FISH positive for any conclusions. HER2 amplification by FISH was unaffected by slide storage. We conclude that use of aged stored slides for proliferation markers TOP2A and Ki67 is feasible but may modestly underestimate true values in endometrial cancer. Pilot studies for particular storage conditions/durations/antigens to be used in translational studies are warranted.
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Affiliation(s)
- Tatyana A. Grushko
- The University of Chicago Medical Center, Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IL USA
| | - Virginia L. Filiaci
- NRG Oncology Statistics and Data Management Center, Roswell Park Comprehensive Cancer Center, Buffalo, NY USA
| | - Anthony G. Montag
- Department of Pathology, The University of Chicago Medical Center, Chicago, IL USA
| | - Marsha Apushkin
- Department of Pathology, The University of Chicago Medical Center, Chicago, IL USA
| | - Maria J. Gomez
- The University of Chicago Medical Center, Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IL USA
| | - Laura Monovich
- Gynecologic Oncology Group Tissue Bank/NRG Oncology Biospecimen Bank, Biopathology Center, Research Institute at Nationwide Children's Hospital, Columbus, OH USA
| | - Nilsa C. Ramirez
- Gynecologic Oncology Group Tissue Bank/NRG Oncology Biospecimen Bank, Biopathology Center, Research Institute at Nationwide Children's Hospital, Columbus, OH USA
| | - Carlton Schwab
- Clinical Research; Gibbs Cancer Center and Research Institute, Spartanburg, SC USA
| | - Joshua P. Kesterson
- Division of Gynecologic Oncology; Penn State Hershey Medical Center, Hershey, PA
| | | | - Michael W. Method
- Division of Gynecological Oncology; Indiana University Hospital/Melvin and Bren Simon Cancer Center; Indianapolis, IN USA
| | - Olufunmilayo I. Olopade
- The University of Chicago Medical Center, Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IL USA
| | - Gini F. Fleming
- The University of Chicago Medical Center, Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IL USA
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Zhang Y, Zhao W, Chen Z, Zhao X, Ren P, Zhu M. Establishment and evaluation of a risk-scoring system for lymph node metastasis in early-stage endometrial carcinoma: Achieving preoperative risk stratification. J Obstet Gynaecol Res 2020; 46:2305-2313. [PMID: 32844525 DOI: 10.1111/jog.14422] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 07/02/2020] [Accepted: 07/26/2020] [Indexed: 12/09/2022]
Abstract
AIM To establish a risk-scoring system for lymph node metastasis (LNM) of early-stage endometrial carcinoma (EC), and to stratify the preoperative risk of LNM. METHODS We retrospectively analyzed the clinical data of 507 patients diagnosed with the early-stage EC (i.e., confined to the uterine corpus). We determined the risk factors for LNM by logistic regression analysis; then constructed a simple logistic scoring system, and an additive scoring system based on the regression coefficient (β), and odds ratio, of each variable, respectively. RESULTS The overall rate of LNM was 9.1% (46/507). Multivariate analysis showed that preoperative serum cancer antigen 125 (CA125) ≥35 U/mL, histopathology of grade 3 and/or type II, depth of myometrial invasion ≥1/2 and positive immunostaining for Ki-67 ≥50%, were independent risk factors for LNM (P < 0.05). The simple logistic and additive scoring systems exhibited good predictive ability (area under the curve [AUC] >0.8). Based on the additive scoring system, the risk of LNM in patients with early-stage EC was classified into three groups: a low-risk group (total score: <5), an intermediate-risk group (total score: 5-10) and a high-risk group (total score: >10). The incidence of LNM differed significantly across these three groups (P < 0.05). CONCLUSION The risk-scoring system constructed in this study can effectively predict the risk of LNM in patients with early-stage EC, achieve preoperative risk stratification and provide a reference guideline for the use of lymphadenectomy.
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Affiliation(s)
- Ying Zhang
- Department of Obstetrics and Gynecology, Anhui Provincial Hospital affiliated to Anhui Medical University, Hefei, China
| | - Weidong Zhao
- Department of Obstetrics and Gynecology, Anhui Provincial Hospital affiliated to Anhui Medical University, Hefei, China.,Department of Obstetrics and Gynecology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - Zhengzheng Chen
- Department of Obstetrics and Gynecology, Anhui Provincial Hospital affiliated to Anhui Medical University, Hefei, China.,Department of Obstetrics and Gynecology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - Xuxu Zhao
- Department of Obstetrics and Gynecology, Anhui Provincial Hospital affiliated to Anhui Medical University, Hefei, China
| | - Pingping Ren
- Department of Obstetrics and Gynecology, Anhui Provincial Hospital affiliated to Anhui Medical University, Hefei, China
| | - Meiling Zhu
- Department of Obstetrics and Gynecology, Anhui Provincial Hospital affiliated to Anhui Medical University, Hefei, China
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Coll-de la Rubia E, Martinez-Garcia E, Dittmar G, Gil-Moreno A, Cabrera S, Colas E. Prognostic Biomarkers in Endometrial Cancer: A Systematic Review and Meta-Analysis. J Clin Med 2020; 9:E1900. [PMID: 32560580 PMCID: PMC7356541 DOI: 10.3390/jcm9061900] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/12/2020] [Accepted: 06/15/2020] [Indexed: 12/23/2022] Open
Abstract
Endometrial cancer (EC) is the sixth most common cancer in women worldwide and its mortality is directly associated with the presence of poor prognostic factors driving tumor recurrence. Stratification systems are based on few molecular, and mostly clinical and pathological parameters, but these systems remain inaccurate. Therefore, identifying prognostic EC biomarkers is crucial for improving risk assessment pre- and postoperatively and to guide treatment decisions. This systematic review gathers all protein biomarkers associated with clinical prognostic factors of EC, recurrence and survival. Relevant studies were identified by searching the PubMed database from 1991 to February 2020. A total number of 398 studies matched our criteria, which compiled 255 proteins associated with the prognosis of EC. MUC16, ESR1, PGR, TP53, WFDC2, MKI67, ERBB2, L1CAM, CDH1, PTEN and MMR proteins are the most validated biomarkers. On the basis of our meta-analysis ESR1, TP53 and WFDC2 showed potential usefulness for predicting overall survival in EC. Limitations of the published studies in terms of appropriate study design, lack of high-throughput measurements, and statistical deficiencies are highlighted, and new approaches and perspectives for the identification and validation of clinically valuable EC prognostic biomarkers are discussed.
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Affiliation(s)
- Eva Coll-de la Rubia
- Biomedical Research Group in Gynecology, Vall Hebron Institute of Research, Universitat Autònoma de Barcelona, CIBERONC, 08035 Barcelona, Spain;
| | - Elena Martinez-Garcia
- Quantitative Biology Unit, Luxembourg Institute of Health, L-1445 Strassen, Luxembourg; (E.M.-G.); (G.D.)
| | - Gunnar Dittmar
- Quantitative Biology Unit, Luxembourg Institute of Health, L-1445 Strassen, Luxembourg; (E.M.-G.); (G.D.)
| | - Antonio Gil-Moreno
- Biomedical Research Group in Gynecology, Vall Hebron Institute of Research, Universitat Autònoma de Barcelona, CIBERONC, 08035 Barcelona, Spain;
- Gynecological Department, Vall Hebron University Hospital, CIBERONC, 08035 Barcelona, Spain
| | - Silvia Cabrera
- Biomedical Research Group in Gynecology, Vall Hebron Institute of Research, Universitat Autònoma de Barcelona, CIBERONC, 08035 Barcelona, Spain;
- Gynecological Department, Vall Hebron University Hospital, CIBERONC, 08035 Barcelona, Spain
| | - Eva Colas
- Biomedical Research Group in Gynecology, Vall Hebron Institute of Research, Universitat Autònoma de Barcelona, CIBERONC, 08035 Barcelona, Spain;
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Bmi-1 Immunohistochemical Expression in Endometrial Carcinoma is Correlated with Prognostic Activity. ACTA ACUST UNITED AC 2020; 56:medicina56020072. [PMID: 32059385 PMCID: PMC7074093 DOI: 10.3390/medicina56020072] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 02/03/2020] [Accepted: 02/10/2020] [Indexed: 12/14/2022]
Abstract
Background and objectives: B-lymphoma Mo-MLV insertion region 1 (Bmi-1) is a stem cell factor that is overexpressed in various human cancer tissues. It has been implicated in cancer cell proliferation, cell invasion, distant metastasis, and chemosensitivity, and is associated with patient survival. Several reports have also identified Bmi-1 protein overexpression in endometrial carcinoma; however, the relationship between Bmi-1 expression and its significance as a clinicopathological parameter is still insufficiently understood. Accordingly, the present study aimed to clarify whether immunohistochemical staining for Bmi-1 in human endometrial carcinoma and normal endometrial tissues can be used as a prognostic and cell proliferation marker. Materials and Methods: Bmi-1 expression was assessed in endometrioid carcinoma (grade 1–3) and normal endometrial tissues (in the proliferative and secretory phases) by immunohistochemistry; protein expression was evaluated using the nuclear labeling index (%) in the hot spot. Furthermore, we examined other independent prognostic and proliferation markers, including the protein levels of Ki-67, p53, and cyclin A utilizing semi-serial sections of endometrial carcinoma tissues. Results: The expression of the Bmi-1 protein was significantly higher in all grades of endometrial carcinoma than in the secretory phase of normal tissues. Moreover, Bmi-1 levels tended to be higher in G2 and G3 tissues than in G1 tissue, without reaching significance. Bmi-1 expression showed no notable differences among International Federation of Gynecology and Obstetrics (FIGO) stages in endometrial carcinoma. Furthermore, we observed a significant positive relationship between Bmi-1 and Ki-67, cyclin A, or p53 by Spearman’s rank correlation test, implying that high Bmi-1 expression can be an independent prognostic marker in endometrial carcinoma. Conclusions: Our study suggests that Bmi-1 levels in endometrial carcinoma tissues may be useful as a reliable proliferation and prognostic biomarker. Recently, the promise of anti-Bmi-1 strategies for the treatment of endometrial carcinoma has been detected. Our results provide fundamental data regarding this anti-Bmi-1 strategy.
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Adomaitienė L, Nadišauskienė R, Nickkho-Amiry M, Čižauskas A, Palubinskienė J, Holland C, Seif MW. Proliferation in Postmenopausal Endometrial Polyps-A Potential for Malignant Transformation. ACTA ACUST UNITED AC 2019; 55:medicina55090543. [PMID: 31466367 PMCID: PMC6780687 DOI: 10.3390/medicina55090543] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 07/31/2019] [Accepted: 08/22/2019] [Indexed: 12/26/2022]
Abstract
Background and objectives: Endometrial polyps in asymptomatic postmenopausal women are often incidentally found, yet only 1.51% of them are malignant. Their potential for malignant transformation has not been adequately addressed. The aim of this study was to investigate the proliferation within endometrial polyps as one of the indicators of their malignization potential in asymptomatic postmenopausal women. Materials and Methods: Immunohistochemical studies of Ki-67 were performed. Cases included 52 benign postmenopausal polyps, 19 endometrioid carcinoma with coexisting benign polyps, 12 polyps with foci of carcinoma and 4 cases of polyps, which later developed carcinoma. The control group included 31 atrophic endometria and 32 benign premenopausal polyps. Ki-67 was scored in either 10 or 20 “hot spot” fields, as percentage of positively stained cells. Results: The median epithelial Ki-67 score in postmenopausal benign polyps (4.7%) was significantly higher than in atrophic endometria (2.41%, p < 0.0001) and significantly lower than in premenopausal benign polyps (11.4%, p = 0.003) and endometrial cancer (8.3%, p < 0.0001). Where endometrial polyps were found in association with endometrial carcinoma, Ki-67 was significantly higher in cancer (p < 0.0001). No significant difference was found between Ki-67 scores of cancer focus and of the polyps tissue itself, respectively 2.8% and 4.55%, p = 0.37. Ki-67 expression, where polyps were resected and women later developed cancer, was not significantly different (p = 0.199). Conclusion: Polyps from asymptomatic postmenopausal women showed significantly more proliferation in both epithelial and stromal components than inactive atrophic endometria but less than premenopausal benign polyps and/or endometrial cancer. Benign postmenopausal endometrial polyps exhibit low proliferative activity, suggesting low malignant potential and may not require resection in asymptomatic women.
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Affiliation(s)
- Lina Adomaitienė
- Department of Obstetrics and Gynaecology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania.
| | - Rūta Nadišauskienė
- Department of Obstetrics and Gynaecology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania
| | - Mahshid Nickkho-Amiry
- Department of Obstetrics and Gynaecology, University of Manchester and St. Mary's Hospital, Manchester M13 9WL, UK
| | - Arvydas Čižauskas
- Department of Patological Anatomy, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania
| | - Jolita Palubinskienė
- Department of Histology and Embryology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania
| | - Cathrine Holland
- Department of Obstetrics and Gynaecology, University of Manchester and St. Mary's Hospital, Manchester M13 9WL, UK
| | - Mourad W Seif
- Department of Obstetrics and Gynaecology, University of Manchester and St. Mary's Hospital, Manchester M13 9WL, UK
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Tuo X, Zhao L, Wang Q, Han L, Wang Y, Ma S, Feng X, Li Q, Sun C, Wang Q, Shi G, Hou H, Zhang G, Li Q. Validation of Molecular Typing for Endometrial Screening Test That Predicts Benign and Malignant Lesions. Front Oncol 2019; 9:561. [PMID: 31338322 PMCID: PMC6629861 DOI: 10.3389/fonc.2019.00561] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 06/10/2019] [Indexed: 12/24/2022] Open
Abstract
The aim of this study is to examine the immunocytochemical expression of p53, Ki-67, and CA125 in endometrial brush samples for endometrial cancer. Forty-four patients were recruited with liquid-based cytology preparations during a 5-month period. Both the histological and cytological samples were assessed by histology based on hematoxylin and eosin (H&E), and the expression of p53, CA125, and Ki-67 in endometrial cells was examined by immunocytochemistry. The percentage and intensity of endometrial cells were scored on a scale of 0-3. The final score was calculated by the addition of all partial scores, and then Probit model was used to predict the possibility for malignant lesions. The mean immunoreactivity score of the three immunocytochemical biomarkers (p53, CA125, and Ki-67) in the positive group (including atypical hyperplastic cells and malignant cells) was significantly higher than in the negative group (benign cells and non-atypical hyperplastic cells). The possibility value of the positive group was also significantly higher than the negative group (P < 0.05). The cutoff value of the possibility value was 0.754, the sensitivity and specificity of which were 86.4 and 95.5%. The assessment of p53, CA125, and Ki-67 combined with the prediction model is valuable for the detection of endometrial cancer and atypical hyperplasia in endometrial cytology.
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Affiliation(s)
- Xiaoqian Tuo
- Department of Gynecology and Obstetrics, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Lanbo Zhao
- Guipei 77, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Qi Wang
- Department of Gynecology and Obstetrics, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Lu Han
- Department of Gynecology and Obstetrics, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Yiran Wang
- Department of Gynecology and Obstetrics, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Sijia Ma
- Department of Gynecology and Obstetrics, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Xue Feng
- Department of Gynecology and Obstetrics, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Qing Li
- Department of Gynecology and Obstetrics, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Chao Sun
- Department of Gynecology and Obstetrics, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Qing Wang
- Department of Gynecology and Obstetrics, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Guizhi Shi
- Aviation General Hospital of Beijing, Medical University and Beijing Institute of Translational Medicine, University of Chinese Academy of Sciences, Beijing, China
| | - Huilian Hou
- Department of Pathology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Guanjun Zhang
- Department of Pathology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Qiling Li
- Department of Gynecology and Obstetrics, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
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Horie K, Yamamoto H, Karube K, Takebayashi K, Yoshino H, Yoshioka H, Watanabe J. Cyclin A is a reliable proliferation marker in endometrial cancer cell lines. Oncol Lett 2019; 17:4455-4462. [PMID: 30988814 PMCID: PMC6447861 DOI: 10.3892/ol.2019.10135] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 02/28/2019] [Indexed: 12/21/2022] Open
Abstract
Cyclin A, a cell cycle regulatory protein, promotes cell proliferation and has been observed to be highly expressed in cancer and to promote tumor growth; however, its value as a marker for endometrial carcinoma has not yet been established. Accordingly, the aim of the present study was to clarify whether cyclin A can be used as a cell proliferation marker using the endometrial carcinoma cell lines Ishikawa and HEC-50B, derived from patients with low-grade and high-grade cancer, respectively. The expression of cyclin A was determined by flow cytometry using double staining with FITC and 7-AAD, and immunocytochemical staining. The results were compared to those of Ki-67, the widely used cell proliferation marker that is considered to be a prognostic marker in endometrial cancer. The flow cytometry results revealed that cyclin A expression was significantly higher in HEC-50B than in Ishikawa cells during the logarithmic growth phase. In addition, cyclin A expression was consistently higher than Ki-67 expression in the examined cell lines. Immunocytochemical staining confirmed cyclin A expression in HEC-50B and Ishikawa cells, demonstrating significantly higher expression during the logarithmic growth phase than during the stationary phase. By contrast, Ki-67 was expressed in almost 90% of the cells, irrespective of their growth state. These results indicate that cyclin A expression is significantly increased in cells with higher proliferative ability and is specifically expressed in cells that have passed the G1-S checkpoint. Therefore, cyclin A may be a reliable proliferation biomarker for endometrioid carcinoma.
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Affiliation(s)
- Kayo Horie
- Department of Bioscience and Laboratory Medicine, Hirosaki University Graduate School of Health Sciences, Hirosaki, Aomori 036-8564, Japan
| | - Hayate Yamamoto
- Department of Medical Technology, Hirosaki University School of Health Sciences, Hirosaki, Aomori 036-8564, Japan
| | - Kouhei Karube
- Department of Medical Technology, Hirosaki University School of Health Sciences, Hirosaki, Aomori 036-8564, Japan
| | - Kai Takebayashi
- Department of Bioscience and Laboratory Medicine, Hirosaki University Graduate School of Health Sciences, Hirosaki, Aomori 036-8564, Japan
| | - Hironori Yoshino
- Department of Bioscience and Laboratory Medicine, Hirosaki University Graduate School of Health Sciences, Hirosaki, Aomori 036-8564, Japan
| | - Haruhiko Yoshioka
- Department of Bioscience and Laboratory Medicine, Hirosaki University Graduate School of Health Sciences, Hirosaki, Aomori 036-8564, Japan
| | - Jun Watanabe
- Department of Bioscience and Laboratory Medicine, Hirosaki University Graduate School of Health Sciences, Hirosaki, Aomori 036-8564, Japan
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11
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Ueda J, Yoshida H, Mamada Y, Taniai N, Yoshioka M, Hirakata A, Kawano Y, Mizuguchi Y, Shimizu T, Kanda T, Takata H, Kondo R, Uchida E. Evaluation of positive ductal margins of biliary tract cancer in intraoperative histological examination. Oncol Lett 2018; 16:6677-6684. [PMID: 30405808 DOI: 10.3892/ol.2018.9479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 09/13/2018] [Indexed: 12/22/2022] Open
Abstract
At present the only method available to confirm microscopic infiltration of cancer into ductal margins during surgery, is intraoperative histological examination. In the present study, the status of the surgical margins and postoperative course were evaluated to determine any correlation between remnant carcinoma and postoperative survival. All consecutive patients who underwent resection for biliary tract cancer between January 2004 and May 2012 were identified from a database. Positive margin cases were divided into two groups, invasive carcinoma and carcinoma in situ (CIS). Immunohistochemical staining targeting Ki67 and p53 for positive margins was performed. Cases of major vessel invasion were significantly increased in the positive group compared with the negative group. The recurrence rate was significantly lower in the CIS group compared with the invasive group. The survival rate was significantly increased in the CIS group compared with the invasive group. The expression levels of p53 and Ki67 were significantly increased in the invasive group compared with the CIS group. No statistical correlations were observed between the expression of p53 or Ki67 and the survival or recurrence of disease. In the positive group, resected margin status was the principal factor associated with recurrence-free survival according to Cox-regression analysis. In conclusion, the status of the resected margins in the positive group was the most important factor for postoperative survival and recurrence in cholangiocarcinoma, not immunohistochemical staining targeting Ki67 and p53.
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Affiliation(s)
- Junji Ueda
- Department of Surgery, Nippon Medical School, Bunkyo-ku, Sendagi, Tokyo 113-8603, Japan.,Department of Surgery, Nippon Medical School Tamanagayama Hospital, Tokyo 206-8512, Japan
| | - Hiroshi Yoshida
- Department of Surgery, Nippon Medical School Tamanagayama Hospital, Tokyo 206-8512, Japan
| | - Yasuhiro Mamada
- Department of Surgery, Nippon Medical School, Bunkyo-ku, Sendagi, Tokyo 113-8603, Japan
| | - Nobuhiko Taniai
- Department of Surgery, Nippon Medical School, Bunkyo-ku, Sendagi, Tokyo 113-8603, Japan
| | - Masato Yoshioka
- Department of Surgery, Nippon Medical School, Bunkyo-ku, Sendagi, Tokyo 113-8603, Japan
| | - Atsushi Hirakata
- Department of Surgery, Nippon Medical School Tamanagayama Hospital, Tokyo 206-8512, Japan
| | - Youichi Kawano
- Department of Surgery, Nippon Medical School, Bunkyo-ku, Sendagi, Tokyo 113-8603, Japan
| | - Yoshiaki Mizuguchi
- Department of Surgery, Nippon Medical School, Bunkyo-ku, Sendagi, Tokyo 113-8603, Japan
| | - Tetsuya Shimizu
- Department of Surgery, Nippon Medical School, Bunkyo-ku, Sendagi, Tokyo 113-8603, Japan
| | - Tomohiro Kanda
- Department of Surgery, Nippon Medical School, Bunkyo-ku, Sendagi, Tokyo 113-8603, Japan
| | - Hideyuki Takata
- Department of Surgery, Nippon Medical School Tamanagayama Hospital, Tokyo 206-8512, Japan
| | - Ryota Kondo
- Department of Surgery, Nippon Medical School, Bunkyo-ku, Sendagi, Tokyo 113-8603, Japan
| | - Eiji Uchida
- Department of Surgery, Nippon Medical School, Bunkyo-ku, Sendagi, Tokyo 113-8603, Japan
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12
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Zhao Y, Sun H, Feng M, Zhao J, Zhao X, Wan Q, Cai D. Metformin is associated with reduced cell proliferation in human endometrial cancer by inbibiting PI3K/AKT/mTOR signaling. Gynecol Endocrinol 2018; 34:428-432. [PMID: 29182407 DOI: 10.1080/09513590.2017.1409714] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Metformin recently gained traction as potential anti-endometrial cancer agent for its new applications. However, the underlying mechanisms of the anti-cancer effect of metformin in the endometrial cancer have not yet been fully elucidated. Sixty-five patients diagnosed as endometrial carcinoma were grouped into (n = 33) and non-treatment mixed (n = 32) for analysis. Thirty healthy donors were recruited as controls. We attempt to investigate the effect of metformin on Ki-67, PI3K, p-AKT, p-S6K1, and p-4EBP1 staining in human endometrial cancer by immunohistochemical staining. We found that increased Ki-67 expression in women with endometrial cancer, which were reversed by conventional anti-diabetic doses of metformin in present work. In parallel, the reduced PI3K, p-AKT, p-S6K1, and p-4EBP1 staining induced by metformin appeared to play an important role for the anti-proliferative effects of metformin in endometrial cancer patients. Metformin significantly decreased proliferation in human endometrial cancer may by inhibiting PI3K/AKT/mTOR signaling. Our present results add to the growing body of evidence supporting metformin as a potential anti-cancer agent in endometrial cancer.
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Affiliation(s)
- Yan Zhao
- a Department of Obstetrics and Gynecology , The Second Affiliated Hospital of Xi'an Jiaotong University , Xi'an , Shaanxi , PR China
| | - Hongli Sun
- b Shaanxi Institute of Pediatric Diseases , The Affiliated children's hospital of Xi'an Jiaotong University , Xi'an , Shaanxi , PR China
| | - Minjuan Feng
- a Department of Obstetrics and Gynecology , The Second Affiliated Hospital of Xi'an Jiaotong University , Xi'an , Shaanxi , PR China
| | - Jinyan Zhao
- a Department of Obstetrics and Gynecology , The Second Affiliated Hospital of Xi'an Jiaotong University , Xi'an , Shaanxi , PR China
| | - Xiaogui Zhao
- a Department of Obstetrics and Gynecology , The Second Affiliated Hospital of Xi'an Jiaotong University , Xi'an , Shaanxi , PR China
| | - Qiuyuan Wan
- a Department of Obstetrics and Gynecology , The Second Affiliated Hospital of Xi'an Jiaotong University , Xi'an , Shaanxi , PR China
| | - Dongge Cai
- a Department of Obstetrics and Gynecology , The Second Affiliated Hospital of Xi'an Jiaotong University , Xi'an , Shaanxi , PR China
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13
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Jiang JX, Zhao JL, Zhang Q, Qing JF, Zhang SQ, Zhang YM, Wu XH. Endometrial carcinoma: diffusion-weighted imaging diagnostic accuracy and correlation with Ki-67 expression. Clin Radiol 2017; 73:413.e1-413.e6. [PMID: 29246587 DOI: 10.1016/j.crad.2017.11.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 11/14/2017] [Indexed: 01/09/2023]
Abstract
AIM To evaluate the role of diffusion-weighted imaging (DWI) in the detection of endometrial carcinoma and to correlate the apparent diffusion coefficient (ADC) value with Ki-67 expression. MATERIALS AND METHODS Fifty-two patients with invasive cancer who underwent pelvic MRI were prospectively evaluated using DWI with b-values of 0 and 1000 s/mm2.The ADC values from standard DWI were measured. The expression of Ki-67 in histological specimens was analysed using immunohistochemistry. The ADC values of endometrial carcinoma and normal endometrial parenchyma were compared. Relationships between ADC values and Ki-67 expression were determined using Wilcoxon's signed rank test and the Kruskal-Wallis test. RESULTS Endometrial carcinoma was detected at DWI as a hyperintense area in 92.3% (48/52) of patients. There was a significant difference in the mean ADC values between endometrial carcinoma and normal endometrial parenchyma (1.39±0.27×10-3 versus 0.93±0.21×10-3 mm2/s, p<0.001). The mean ADC values of grade 1 patients were significantly higher than those of grade 3 patients (1.01±0.16×10-3 versus 0.83±0.21×10-3 mm2/s, p<0.05). The mean ADC values of stage IB patients were significantly lower than those of stage IA patients (0.86±0.16×10-3 versus 1.04±0.21×10-3 mm2/s, p<0.01). The mean ADC values of high Ki-67 expression patients were significantly lower than those of low Ki-67 expression patients (0.82±0.12×10-3 versus 1.16±0.12×10-3 mm2/s, p<0.001). There was a significant negative correlation between the mean ADC value and Ki-67 expression (r=-0.82, p<0.001). CONCLUSION The ADC value was a helpful parameter for detecting the tumour grade, stage, and proliferation of endometrial carcinoma, and may further improve patient prognosis and contribute to the development of more effective treatment programmes.
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Affiliation(s)
- J X Jiang
- Department of Radiology, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - J L Zhao
- Department of Radiology, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Q Zhang
- Department of Pathology, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - J F Qing
- Department of Radiology, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - S Q Zhang
- Department of Radiology, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Y M Zhang
- Department of Radiology, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - X H Wu
- Department of Radiology, Affiliated Hospital of Nantong University, Nantong, 226001, China.
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14
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Comparative study of different histologic classifications in the degree of differentiation in endometrial adenocarcinoma. TUMORI JOURNAL 2016; 102:488-495. [PMID: 27514311 DOI: 10.5301/tj.5000528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the concordance among the available histologic classifications for endometrial adenocarcinoma using interobserver and intraobserver agreement as well as the association of tumor histologic degree in the above mentioned classifications with cellular proliferation measured by Ki-67. METHODS Seventy women who underwent surgical treatment of endometrial adenocarcinoma with histologic confirmation of endometrioid type were included in the study. Two experienced pathologists randomly analyzed the slides in 3 distinct timeframes with a maximum of 25 slides/timeframe. Tumor slides were classified according to the degree of differentiation using 4 different classifications: International Federation of Gynecology and Obstetrics (FIGO), modified FIGO, Lax, and Alkushi. RESULTS Intraobserver agreement was reasonable for classification of FIGO (k 0.469 and 0.538), very good for modified FIGO (k 0.661 and 0.768), moderate for Lax classification (k 0.496 and 0.466), and moderate/good for Alkushi classification (k 0.528 and 0.736). Interobserver concordance was regular for FIGO classification (k = 0.271 and 0.343), good/moderate for modified FIGO classification (k = 0.661 and 0.522, respectively), regular/moderate for Lax classification (k = 0.258 and 0.465, respectively), and regular for Alkushi classification (k = 0.283 and 0.402). CONCLUSIONS The prognostic value of histologic grading in endometrial carcinoma and its importance for a successful therapeutic plan have been documented repeatedly, but the best grading system, in terms of prognostication, reproducibility, ease of use, and universality (e.g., applicability to all tumor cell types), has not been unequivocally defined.
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15
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Baxi SN, Panchal NS. Histopathology-like categories based on endometrial imprint cytology in dysfunctional uterine bleeding. J Cytol 2015; 32:96-101. [PMID: 26229245 PMCID: PMC4520055 DOI: 10.4103/0970-9371.160558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Cytology of the endometrium is an underused technique in diagnostic pathology. It has been used in the past for endometrial hyperplasia and carcinoma. Only few studies have used cytology in the diagnosis of dysfunctional uterine bleeding (DUB). Endometrial imprint cytology has been rarely used except for application of immunocytochemistry in diagnosis of endometrial carcinoma. Aim: The present study was conducted to evaluate whether it is possible to assign histopathology-like diagnosis by imprint cytology and also to evaluate its usefulness in the assessment of patients of dysfunctional uterine bleeding of low clinical suspicion. Materials and Methods: Imprint smears were made from 93 curettage materials during a study of DUB. Blinded analysis of imprint smears was performed by using McKenzie's criteria and some criteria devised for the requirements of this study. Results of cytology were correlated with histopathology. Statistical analysis was carried out by GraphpadInStat Demo. Results: Majority of the patterns classifiable in histopathology could also be classified in this study on imprint cytology. The overall sensitivity and specificity of cytology in the detection of endometrial patterns in DUB patients were 91.23% and 83.87%, respectively, although the sensitivities and specificities differ according to the phase of endometrium. Conclusion: Histopathology-like categories can be assigned on imprint smears in the diagnosis of DUB. Endometrial imprint cytology can be helpful in centers where histopathology laboratories are not available and even in well-established institutes. It is possible to improve the sensitivity and specificity with better imprinting techniques.
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Affiliation(s)
- Seema N Baxi
- Department of Pathology, Government Medical College, Bhavnagar, Gujarat, India
| | - Nirav S Panchal
- Department of Pathology, Government Medical College, Bhavnagar, Gujarat, India
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16
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Gardner CS, Sunil J, Klopp AH, Devine CE, Sagebiel T, Viswanathan C, Bhosale PR. Primary vaginal cancer: role of MRI in diagnosis, staging and treatment. Br J Radiol 2015; 88:20150033. [PMID: 25966291 DOI: 10.1259/bjr.20150033] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Primary carcinoma of the vagina is rare, accounting for 1-3% of all gynaecological malignancies. MRI has an increasing role in diagnosis, staging, treatment and assessment of complications in gynaecologic malignancy. In this review, we illustrate the utility of MRI in patients with primary vaginal cancer and highlight key aspects of staging, treatment, recurrence and complications.
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Affiliation(s)
- C S Gardner
- 1 Department of Diagnostic Radiology, Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - J Sunil
- 1 Department of Diagnostic Radiology, Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - A H Klopp
- 2 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - C E Devine
- 1 Department of Diagnostic Radiology, Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - T Sagebiel
- 1 Department of Diagnostic Radiology, Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - C Viswanathan
- 1 Department of Diagnostic Radiology, Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - P R Bhosale
- 1 Department of Diagnostic Radiology, Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Apostolou G, Apostolou N, Nikolaidou C, Kavantzas N, Patsouris E, Athanassiadou P. Cytodiagnosis of endometrial carcinoma and hyperplasia on imprint smears with additional immunocytochemistry using Ki-67 and p53 biomarkers. Cytopathology 2013; 25:86-94. [DOI: 10.1111/cyt.12095] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2013] [Indexed: 11/30/2022]
Affiliation(s)
- G. Apostolou
- Department of Cytopathology; Anti-cancer Oncological Hospital St. Savvas; Athens Greece
| | - N. Apostolou
- Department of Biomedical Engineering; Olympic Polyclinic; Athens Greece
| | - C. Nikolaidou
- Department of Pathology; Anti-cancer Oncological Hospital Theagenio; Thessaloniki Greece
| | - N. Kavantzas
- Department of Pathology; Medical School; Athens University; Athens Greece
| | - E. Patsouris
- Department of Pathology; Medical School; Athens University; Athens Greece
| | - P. Athanassiadou
- Department of Cytology; Medical School; Athens University; Athens Greece
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18
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Apostolou G, Apostolou N, Biteli M, Kavantzas N, Patsouris E, Athanassiadou P. Utility of Ki-67, p53, Bcl-2, and Cox-2 biomarkers for low-grade endometrial cancer and disordered proliferative/benign hyperplastic endometrium by imprint cytology. Diagn Cytopathol 2013; 42:134-42. [PMID: 23729350 DOI: 10.1002/dc.23010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 02/15/2013] [Accepted: 04/04/2013] [Indexed: 12/17/2022]
Abstract
In this report, the authors examined the characteristic features of morphology and molecular biology of Ki-67, p53, Bcl-2, and cyclooxygenase-2 (Cox-2) immunocytochemistry in low-grade endometrioid endometrial carcinoma (LG-ENEC) and disordered proliferative (DP)/benign hyperplastic (BH) endometrium. We carried out a prospective study by collecting endometrial imprints from freshly resected uteri over a 20-month period and finally 104 patients were evaluated with endometrial cytology. We focused on LG-ENECs, as well as on BH endometrium and its precursor lesion, DP endometrium, firstly because of the overlapping cytomorphology of these pathologic entities and secondly because of the lack of agreement in the differential diagnosis of atypical hyperplasia from complex hyperplasia and well-differentiated endometrial carcinoma, even in curettage specimens. Ki-67 expression of LG-ENEC showed predominance in comparison with DP/BH endometrium. Furthermore, high levels of Bcl-2 (>50%) were expressed only in DP/BH endometrium. DP/BH endometrium was negative for p53 marker, except from two cases of BH endometrium. Cox-2 expression ≥50% was found only in LG-ENECs. Using Ki-67, Bcl-2, p53, and Cox-2 markers, we managed to distinguish fully DP/BH endometrium from LG-ENEC. Higher Ki-67%/Bcl-2% rate and also higher Cox-2 expression were found in LG-ENEC cases with FIGO stage ≥ IC, than in cases with FIGO stage < IC. The immunocytochemical findings from a combination of Ki-67, p53, Bcl-2, and Cox-2, may differentiate LG-ENEC from DP/BH endometrium with overlapping cytomorphology. Immunocytochemistry appeared to be useful also for the correlation between LG-ENEC and FIGO stage.
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Affiliation(s)
- George Apostolou
- Department of Cytopathology, Anti-cancer Oncological Hospital St. Savvas, Athens, Greece
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19
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Danescu A, Herrero Gonzalez S, Di Cristofano A, Mai S, Hombach-Klonisch S. Three-dimensional nuclear telomere architecture changes during endometrial carcinoma development. Genes Chromosomes Cancer 2013; 52:716-32. [PMID: 23630056 DOI: 10.1002/gcc.22067] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2012] [Accepted: 03/21/2013] [Indexed: 01/06/2023] Open
Abstract
Endometrioid or type-I endometrial carcinoma (EC) develops from hyperproliferative glandular pathologies. Inactivation of the tumor suppressor gene PTEN is frequently associated with type-I EC. Using a previously characterized Pten heterozygous (Pten+/-) mouse model, this study investigates the three-dimensional (3D) telomere profiles during progression from hyperplastic lesions to EC to test the hypothesis that altered 3D telomere profiles can be detected prior to Pten loss in early hyperproliferative lesions. We used immunohistochemistry and 3D-telomere fluorescent in-situ hybridization to investigate Pten expression, telomere length and signal distribution, average number and spatial distribution of telomeres and formation of telomere aggregates in uterine glandular epithelial cells from wildtype and Pten+/- mice. Pten showed nuclear and cytoplasmic localization in WT, predominantly cytoplasmic staining in simple hyperplasia (SH) and was markedly reduced in atypical hyperplasia (AH). Telomere length in glandular epithelial cells does not shorten with age. The average number of telomeres per nucleus was not different in WT and Pten+/- mice indicating the lack of substantial numeric chromosome aberrations during EC development. We observed telomere aggregates in lesions of AH and EC. SH lesions in Pten+/- mice differed from normal glandular epithelium by an increased relative number of shorter telomeres and by a telomere signal distribution indicative of a heterogeneous cell population. Our study revealed that alterations in the nuclear 3D telomere architecture are present in early proliferative lesions of mouse uterine tissues indicative of EC development. The changes in telomere length distribution and nuclear signal distribution precede the loss of Pten.
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Affiliation(s)
- Adrian Danescu
- Department of Human Anatomy and Cell Science, University of Manitoba, Winnipeg, Canada
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