Immunohistochemical profile of endometrial adenocarcinoma: A study of 61 cases and review of the literature

The differences in immunohistochemical expression of p53, bcl-2, bar, estro gen receptor (ER), and progesterone receptor (PR) were evaluated in 40 endo metrioid and 21 papillary serous carcinomas of endometrium and correlated w ith known predictors of survival, such as grade and stage. Uterine papillar y serous adenocarcinomas (UPSA) showed significantly higher p53 expression than did uterine endometrioid adenocarcinomas (UEA) (76.2% versus 35%), whe reas both ER and PR were more often positive in endometrioid than in serous tumors (p=.005 and .0005). No significant difference was found in bcl-2 an d bar expression between both histologic types. However, there was definite decrease in intensity of bcl-2 in UPSA compared with UEA, In endometrioid carcinoma, p53 overexpression was associated with high-grade and advanced-s tage tumors (p =.0006 and .006), whereas ER and PR expression was associate d with low-grade and early-stage tumors (p =.0006 and .0001; p = .003 and . 0006), Bcl-2 immunopositivity was more common in low-grade, early-stage rat her than in high-grade, advanced-stage adenocarcinomas, but the difference was not statistically significant (p = .24 and .07), Bax immunopositivity w as associated with well-differentiated (p = .04) and early-stage tumors. Fu rthermore, a significant inverse relationship between bar and p53 reactivit y was defined (p = .05), especially in tumors of endometrioid type. Bar and PR immunoexpression correlated near the limit of statistical significance (p = .08), whereas no relationship was found among bar, bcl-2, and ER immun opositivity, Our results indicate that the differences in immunohistochemic al profiles of endometrioid and serous carcinomas support the existence of different molecular pathways of their development. The correlation of immun ohistochemical findings with histologic grade and clinical stage could help in predicting biologic behavior and planning treatment in patients who are diagnosed as having these tumors.