RT Journal Article
SR Electronic
T1 Clinicopathologic Analysis With Immunohistochemistry for DNA Mismatch Repair Protein Expression in Synchronous Primary Endometrial and Ovarian Cancers
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP 440
OP 446
DO 10.1097/IGC.0000000000000377
VO 25
IS 3
A1 Kobayashi, Yusuke
A1 Nakamura, Kanako
A1 Nomura, Hiroyuki
A1 Banno, Kouji
A1 Irie, Haruko
A1 Adachi, Masataka
A1 Iida, Miho
A1 Umene, Kiyoko
A1 Nogami, Yuya
A1 Masuda, Kenta
A1 Kisu, Iori
A1 Ueki, Arisa
A1 Yamagami, Wataru
A1 Kataoka, Fumio
A1 Hirasawa, Akira
A1 Tominaga, Eiichiro
A1 Susumu, Nobuyuki
A1 Aoki, Daisuke
YR 2015
UL http://ijgc.bmj.com/content/25/3/440.abstract
AB Objective Synchronous primary endometrial and ovarian cancers have been an important topic in clinical medicine because it is sometimes difficult to distinguish whether there are 2 primary tumors or a single primary tumor and an associated metastasis. In addition, although these tumors are recommended for either immunohistochemistry for DNA mismatch repair (MMR) proteins or a microsatellite instability test in the Bethesda guidelines as Lynch syndrome–associated cancers, few studies have completed these analyses. In this study, we characterized the clinicopathologic features and the expression pattern of MMR proteins in synchronous primary endometrial and ovarian cancers.Methods Clinicopathologic features and the expression pattern of MMR proteins (MLH1, MSH2, and MSH6) were characterized and analyzed in 32 synchronous primary endometrial and ovarian cancers.Results Most synchronous cancers are endometrioid type (endometrioid/endometrioid) (n = 24, 75%), grade 1 (n = 19, 59.4%), and diagnosed as stage I (n = 15, 46.9%) in both endometrium and ovary. It is worth mentioning that 75% of the patients (n = 24) had endometriosis, which was more common (n = 21, 87.5%) in endometrioid/endometrioid cancers, whereas only 3 cases (37.5%) were of different histology (P = 0.018). Loss of expression of at least 1 MMR protein was observed in 17 (53.1%) of the endometrial tumors and in 10 (31.3%) of ovarian tumors. Only 4 cases (12.5%) that had specific MMR protein loss showed the same type of loss for both endometrial and ovarian tumors, in which 3 of the cases were losses in MLH1. One case showed concordant MSH6 protein loss, although the cases did not meet the Amsterdam criteria II.Conclusions These results suggest that most synchronous primary endometrial ovarian cancers are not hereditary cancers caused by germ line mutations but rather sporadic cancers.