| Prognostic markers for coexistent carcinoma in high-risk endometrial hyperplasia with negative D-score: significance of morphometry, hormone receptors and apoptosis for outcome prediction. | |
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MedLine Citation:
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PMID: 19900140 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Hysterectomy represents the current routine therapy for high-risk endometrial precancers. More sophisticated methods are needed for treatment decision among women who want to preserve fertility and seriously ill patients. Among women diagnosed with high-risk hyperplasia, approximately 40% show signs of endometrial cancer in the hysterectomy specimen. Thus, more sophisticated methods are needed to select the women at risk. SETTING: University Hospital of Tromsø, Regional Center for Gynecological Oncology in northern Norway. POPULATION: From 1999 to 2004, 258 consecutive patients had endometrial hyperplasia diagnosed by D-score; 57 among these were high-risk cases (D-score < 0) and 10 had coexisting endometrial carcinoma. No further cancers were detected after long-term follow-up (4-10 years). DESIGN: From the initial histological specimens, material from the 10 patients with cancer and from the 13 cases without cancer (high-risk D-score < 0) was analyzed with selected histomorphometric (architectural and nuclear) and immunohistochemical (hormone receptors and apoptotic) features blinded to the investigator. METHOD: Original slides were used for computerized histomorphometry (4-class rule and related procedures). Serial sections from the paraffin embedded material were used for immunohistochemical investigations. Immunohistochemical expression in glands and stroma was evaluated by the semi-quantitative H-score (ER-alpha, ER-beta, PR-A, PR-B, RCAS-1, Bcl-2, BAX, and Caspase-3). RESULTS: The histomorphometric 4-class rule differentiates between presence and absence of cancers with a sensitivity of 80% and specificity of 77%. Several morphometric and immunohistochemical features were significantly different in cases with cancer and hyperplasia. CONCLUSIONS: Histomorphometry seems superior in predicting coexistent carcinoma in high-risk endometrial hyperplasia and should be considered for clinical use. |
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Authors:
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Anne Ørbo; Turid Kaino; Marit Arnes; Kurt Larsen; Inger Pettersen; Bjørn Moe |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Acta obstetricia et gynecologica Scandinavica Volume: 88 ISSN: 1600-0412 ISO Abbreviation: Acta Obstet Gynecol Scand Publication Date: 2009 |
Date Detail:
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Created Date: 2009-11-10 Completed Date: 2009-12-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370343 Medline TA: Acta Obstet Gynecol Scand Country: England |
Other Details:
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Languages: eng Pagination: 1234-42 Citation Subset: IM |
Affiliation:
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Research Group of Gynecologic Oncology, Institute of Medical Biology, Faculty of Medicine, University of Tromsø, Tromsø, Norway. anne.orbo@fagmed.uit.no |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Apoptosis / physiology* Biopsy Carcinoma, Endometrioid / diagnosis*, metabolism, pathology, ultrastructure Endometrial Hyperplasia / diagnosis*, metabolism, pathology, surgery Endometrial Neoplasms / diagnosis*, metabolism, pathology, ultrastructure Female Humans Immunohistochemistry Middle Aged Predictive Value of Tests Prognosis Receptors, Estrogen / metabolism* Receptors, Progesterone / metabolism* Risk Factors Sensitivity and Specificity Tumor Markers, Biological / metabolism* |
| Chemical | |
Reg. No./Substance:
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0/Receptors, Estrogen; 0/Receptors, Progesterone; 0/Tumor Markers, Biological |
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