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Clear cell adenocarcinoma of the endometrium is a biologically distinct entity from endometrioid adenocarcinoma
  1. T. Arai*,
  2. J. Watanabe,
  3. M. Kawaguchi*,
  4. Y. Kamata*,
  5. Y. Nishimura*,
  6. T. Jobo*, and
  7. H. Kuramoto*,
  1. *Department of Clinical Cytology, Graduate School of Medical 0Sciences, Kitasato University, Kanagawa, Japan
  2. Department of Pathology, Kitasato University School of Medicine, Kanagawa, Japan
  3. Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Kanagawa, Japan
  1. Address correspondence and reprint requests to: Tsutomu Arai, MD, Department of Clinical Cytology, Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Sagamihara, Kanagawa 228-8555, Japan. Email: tutomu.a{at}kitasato-u.ac.jp

Abstract

Clear cell adenocarcinoma (CCA) of the endometrium has a poor prognosis, although the biologic features of this rare tumor are not clear. In this study, we analyzed the expression of biologic markers relating to carcinogenesis, tumor growth, and progression. Thirteen cases of CCA were compared with cases of endometrioid adenocarcinoma (EMA) of the endometrium. Immunohistochemical staining for p53; Ki-67; cyclins A, D1, and E; E-cadherin; progesterone receptor (PR)-A and PR-B; P-glycoprotein; MLH1; and MSH2 was performed. Labeling indices of p53, Ki-67, and cyclins A, D1, and E in CCA were 46.4 ± 24.3%, 52.1 ± 20.5%, 37.9 ± 21.4%, 12.3 ± 27.9%, and 8.2 ± 22.9%, respectively. E-cadherin was expressed in only 1 case (7.7%) of CCA, as compared to 39 cases (61.0%) of EMA. No CCAs were positive for PR-A and PR-B. P-glycoprotein was detected in seven cases (53.8%). Loss of either MLH1 or MSH2 expression occurred in eight cases (61.5%). High-level expression of p53, cyclin A, and P-glycoprotein, and low-level or no expression of cyclin E, E-cadherin, PR-A, and PR-B was observed in CCA compared with EMA. The mechanism of cell-cycle regulation in endometrial CCA is different from that in EMA and may influence its malignant potential. Endometrial CCA is a distinct entity from EMA.

  • carcinogenesis
  • cell cycle
  • clear cell adenocarcinoma of endometrium
  • E-cadherin
  • immunohistochemistry

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