A Clinicopathological Study: Expression of ER, PR and HER/2neu in Endometrial Carcinoma
Author(s): Jasmeen Kaur, Anil Suri, Manjit Kaur
Endometrial carcinoma is a common invasive malignancy of the female genital tract. Investigation of endometrial immunomarkers involved in carcinogenesis may influence early detection and treatment, with direct impact on prognosis by increasing life expectancy. It can often be difficult to distinguish higher grade endometrioid carcinomas from serous carcinomas. Use of immunohistochemistry as an adjunct has been the subject of a number of recent studies.
Aims and Objectives: To study the association of endometrial carcinoma with relation to age, parity and other presenting feature. To determine the association between the expression of ER, PR, and Her-2/neu and clinicopathological features of endometrial carcinoma patients. To correlate the endometrial histopathology with immunohistochemistry.
Material and methods: The present study comprised of analysis of 50 cases of endometrial carcinoma received in the Department of Pathology, Government Medical College, Patiala from January 2018 to May 2020. Routine Haematoxylin and Eosin and on confirmed cases of endometrial carcinoma , IHC for ER, PR and HER-2/neu was performed.
Results: Endometrioid carcinomas showed maximum incidence around the age of 65 with G1 tumours - 56%, G2 - 12%, G3 - 18 % and non Endometrioid were mostly serous and clear representing 14% cases. The predominance of grade-I endometrial carcinoma was found in 56% followed by grade-II in 12% and grade-III in 18% cases. Statistical analysis showed that the degree of differentiation significantly correlated (very highly significant) significant) with histology (p value .000). Out of 50 cases of EMC, 32(64%) cases showed ER positivity. PR positivity was seen in 30(60%) cases and HER-2/neu immunehistochemical expression was positive in 11(22%) cases.
Conclusion: A decrease of the hormonal receptors expression, ER and PR was observed in parallel with the decreased histological degree of differentiation, the lowest values occurring in the case of Endometrioid G3 carcinomas and were absent in Non-Endometrioid carcinomas. This finding may be of a particular clinical importance because almost half of poorly differentiated endometrial carcinomas contain estrogen/progesterone receptors and they might benefit from a progesterone therapy. PR immuneexpression showed statistically significant association with parity, presenting symptom, type, and grade of EMC. Here by, making it an independent prognostic factor.