p53 Immunohistochemistry staining patterns and prognosis significance in 212 cases of non-endometrioid endometrial cancer

IF 2.9 4区医学 Q2 PATHOLOGY

Pathology, research and practice Pub Date : 2024-09-18 DOI:10.1016/j.prp.2024.155595

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Abstract

Objective

To investigate the immunohistochemistry (IHC) staining pattern and prognostic significance of p53 in non-endometrioid endometrial cancer (non-EEC).

Methods

This study retrospectively included 212 non-EEC patients, with histological types including serous carcinoma (SC), clear cell carcinoma (CCC), mixed carcinoma (MC), undifferentiated carcinoma (UC), and carcinosarcoma (CS). p53 IHC was interpreted as normal/wild-type and abnormal/mutant-type, the latter including overexpression, complete absence, and cytoplasmic staining patterns. Moreover, uncommon p53 subclonal/heterogeneous staining patterns were described. Disease-free survival (DFS) and overall survival (OS) were employed as endpoints to evaluate the prognostic significance of p53.

Results

In 212 non-EEC cases, 50 (23.6 %) were p53 wild-type, while 162 (76.4 %) displayed abnormal p53 staining. Overexpression was the predominant abnormal p53 staining pattern (122/162), complete absence followed (33/162). All SCs exhibited the mutant p53 staining pattern. The p53 abnormal expression rates in CCC, MC, UC, and CS were 37.5 %, 78.9 %, 35.7 %, and 75.7 %, respectively. Interestingly, of the 12 MC cases with SC components, barring one with p53 subclonal staining, all showed the mutant-type staining. The concordance rate for p53 expression between epithelial and mesenchymal components of CS was 94.3 % (66/70). Kaplan-Meier curves indicated patients with p53 abnormalities had worse DFS compared to those with wild-type p53 (P=0.025). Multivariate Cox regression confirmed that p53 (HR: 2.270, 95 % CI: 1.124–4.586, P=0.022) independently predicted DFS in non-EEC patients, though not for OS.

Conclusions

Non-EEC patients with various histological types exhibit different p53 staining patterns. However, abnormal p53 expression, regardless of histological type, implies a poor DFS in non-EEC patients.

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212 例非子宫内膜样内膜癌的 p53 免疫组化染色模式及预后意义

方法本研究回顾性纳入了 212 例非子宫内膜癌患者，组织学类型包括浆液性癌（SC）、透明细胞癌（CCC）、混合性癌（MC）、未分化癌（UC）和癌肉瘤（CS）。p53 IHC 被解释为正常/野生型和异常/中毒性型，后者包括过表达、完全缺失和胞质染色模式。此外，还描述了不常见的 p53 亚克隆/异质染色模式。无病生存期（DFS）和总生存期（OS）是评估 p53 预后意义的终点。过表达是最主要的 p53 染色异常模式（122/162），其次是完全缺失（33/162）。所有 SCs 都表现出突变的 p53 染色模式。CCC、MC、UC和CS的p53异常表达率分别为37.5%、78.9%、35.7%和75.7%。有趣的是，在 12 例有 SC 成分的 MC 病例中，除一例有 p53 亚克隆染色外，其余病例均显示突变型染色。CS 上皮和间质成分的 p53 表达一致性为 94.3%（66/70）。Kaplan-Meier曲线显示，与p53野生型患者相比，p53异常患者的DFS较差（P=0.025）。多变量 Cox 回归证实，p53（HR：2.270，95 % CI：1.124-4.586，P=0.022）可独立预测非 EEC 患者的 DFS，但不能预测 OS。然而，无论组织学类型如何，p53表达异常都意味着非EEC患者的DFS较差。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pathology, research and practice 医学-病理学

CiteScore

5.00

自引率

3.60%

发文量

405

审稿时长

24 days

期刊介绍： Pathology, Research and Practice provides accessible coverage of the most recent developments across the entire field of pathology: Reviews focus on recent progress in pathology, while Comments look at interesting current problems and at hypotheses for future developments in pathology. Original Papers present novel findings on all aspects of general, anatomic and molecular pathology. Rapid Communications inform readers on preliminary findings that may be relevant for further studies and need to be communicated quickly. Teaching Cases look at new aspects or special diagnostic problems of diseases and at case reports relevant for the pathologist''s practice.