Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
권호 표지
DOI QR코드

DOI QR Code

Evaluation of the Pathogenesis of Tumor Development from Endometriosis by Estrogen Receptor, P53 and Bcl-2 Immunohistochemical Staining

  • Esmaili, Haidarali (Departments of Pathology, Imam Reza Teaching Hospital, School of Medicine, Tabriz University of Medical Sciences) ;
  • Vahedi, Amir (Departments of Pathology, Imam Reza Teaching Hospital, School of Medicine, Tabriz University of Medical Sciences) ;
  • Mohajeri, Shiva (Departments of Pathology, Imam Reza Teaching Hospital, School of Medicine, Tabriz University of Medical Sciences) ;
  • Mostafidi, Elmira (Departments of Pathology, Imam Reza Teaching Hospital, School of Medicine, Tabriz University of Medical Sciences) ;
  • Azimpouran, Mahzad (Departments of Pathology, Imam Reza Teaching Hospital, School of Medicine, Tabriz University of Medical Sciences) ;
  • Behzad, Mohammad Naghavi (Students' Research Committee, Tabriz University of Medical Sciences)
  • Published : 2016.12.01
⟨ Previous Next ⟩

Abstract

Objective: Endometriosis, one of the most common estrogen dependent gynecological disorders, can present as both benign and malignant disease. The prevalence of tumoral transformation is 0.7-1.6% and the most common tumors are clear cell and endometrioid carcinomas. Unfortunately, the pathogenesis of transformation is unknown. For this purpose, we examined molecular alterations in ovarian endometriosis and endometriosis-associated tumors. Methods: Using the data bank of Alzahra hospital pathology department and paraffin blocks from appropriate cases were identified. Sections were cut and stained for 3 markers: estrogen receptor, P53 and bcl2. Correlations between findings were investigated. Results: Nineteen cases of endometriosis-associated tumor and 19 cases of endometriosis were identified. Staining for bcl2 was documented in 14 of 19 (73.7%) of endometriosis-associated tumor cases and also 7 of 19 (36.8%) endometriosis cases (P=0.02). Only 3 of the 19 (15.8%) endometriosis-associated tumors exhibited positive staining for estrogen receptors, compared with 14 of 19 (73.7%) endometriosis cases (P<0.001). Positive staining for P53 was noted in 5 of 19 (31.6%) endometriosis-associated ovarian tumor samples but was absent in endometriosis samples (0%), (P =0.008). Conclusions: Endometriosis-associated tumors appear to be associated with overexpression of bcl2 and P53 and reduced expression of Estrogen receptor. These finding may help to diagnose tumoral transformation with a background of endometriosis.

Keywords

References

  1. Apostolou G, Apostolou N, Biteli M, et al (2014). Utility of Ki-67, p53, Bcl-2, and Cox-2 biomarkers for low-grade endometrial cancer and disordered proliferative/benign hyperplastic endometrium by imprint cytology. Diagn Cytopathol, 42, 134-42. https://doi.org/10.1002/dc.23010
  2. Bulun S E (2009). Endometriosis. N Engl J Med, 360, 268-79. https://doi.org/10.1056/NEJMra0804690
  3. Chan W Y, Cheung K K , Schorge J O , et al (2000). Bcl-2 and p53 protein expression, apoptosis, and p53 mutation in human epithelial ovarian cancers. Am J Pathol, 156, 409-17. https://doi.org/10.1016/S0002-9440(10)64744-X
  4. Carcangiu M L, Chambers J T, Voynick I M, Pirro M, Schwartz P E (1990). 183 patients with endometrial carcinoma. Part I: Clinical and histologic correlations. Am J Clin Path, 94, 247-54. https://doi.org/10.1093/ajcp/94.3.247
  5. Del Carmen M G , Smith Sehdev A E , Fader A N , et al (2003). Endometriosisassociated ovarian carcinoma: differential expression of vascular endothelial growth factor and estrogen/progesterone receptors. Cancer, 98, 1658-63. https://doi.org/10.1002/cncr.11714
  6. Giudice L C , Kao L C (2004). Endometriosis. Lancet, 364, 1789-99. https://doi.org/10.1016/S0140-6736(04)17403-5
  7. Ho S M (2003). Estrogen, progesterone and epithelial ovarian cancer. Reprod Biol Endocrinol, 1, 73-9. https://doi.org/10.1186/1477-7827-1-73
  8. Kobayashi H, Sumimoto K, Moniwa N, et al (2007). Risk of developing ovarian cancer among women with ovarian endometrioma: a cohort study in Shizuoka, Japan. Int J Gynecol Cancer, 17, 37-43. https://doi.org/10.1111/j.1525-1438.2006.00754.x
  9. Kreizman Shefer H, Pricop J, Goldman S, Elmalah I, Shalev E (2014). Distribution of estrogen and progesterone receptors isoforms in endometrial cancer. Diagn Pathol, 9, 77-85. https://doi.org/10.1186/1746-1596-9-77
  10. Kriplani D, Patel M M (2013). Immunohistochemistry: A diagnostic aid in differentiating primary epithelial ovarian tumors and tumors metastatic to the ovary. South Asian J Can, 4, 254-8.
  11. Mhawech P, Kinkel K, Vlastos G, Pelte MF (2002). Ovarian carcinomas in endometriosis: an immunohistochemical and comparative genomic hybridization study. Int J Gynecol Pathol, 4, 401-6.
  12. Munksgaard P S, Blaakaer J (2012). The association between endometriosis and ovarian cancer: a review of histological, genetic and molecular alterations. Gynecol Oncol, 124, 164-9. https://doi.org/10.1016/j.ygyno.2011.10.001
  13. Nezhat F, Cohen C, Rahaman J, et al (2002). Comparative immunohistochemical studies of bcl-2 and p53 proteins in benign and malignant ovarian endometriotic cysts. Cancer, 94, 2935-40. https://doi.org/10.1002/cncr.10566
  14. Nezhat F, Datta M S, Hanson V, Pejovic T, Nezhat C (2008). The relationship of endometriosis and ovarian malignancy: a review. Fertil Steril, 90, 1559-70. https://doi.org/10.1016/j.fertnstert.2008.08.007
  15. Rosai J (2011). Rosai and Ackerman's Surgical Pathology, 10th edition, Female reproductive system, Mosby. Elsevier 1560-70.
  16. Sampson J A (1925). Endometrial carcinoma of the ovary, arising in endometrial tissue in that organ. Arc Surg, 10, 1-2. https://doi.org/10.1001/archsurg.1925.01120100007001
  17. Salmassi A, Acar-Perk B, Schmutzler AG, et al (2011). Apoptosis resistance in endometriosis. BioImpacts, 1, 129-34.
  18. Shabani N, Kuhn C, Kunze S, et al (2007). Prognostic significance of oestrogen receptor alpha (ERalpha) and beta (ERbeta), progesterone receptor A (PR-A) and B (PR-B) in endometrial carcinomas. Eur J Cancer, 43, 2434-44. https://doi.org/10.1016/j.ejca.2007.08.014
  19. Shen Y M, Wu X L, Xu L, et al (2008). Malignant transformation of ovarian endometriosis: a clinicopathologic analysis of 49 cases. Ai Zheng, 27, 1106-10.
  20. Skirnisdottir I, Sorbe B, Seidal T (2001). P53, bcl-2, and bax: their relationship and effect on prognosis in early stage epithelial ovarian carcinoma. Int J Gynecol.Cancer, 11, 147-58.
  21. Terada T (2012). Endometrioid adenocarcinoma of the ovary arising in atypical endometriosis. Int J Clin Exp Pathol, 5, 924-7.
  22. Thomas E J, Campbell I G (2000). Evidence that endometriosis behaves in a malignant manner. Gynecol Obstet Invest, 50, 2-10. https://doi.org/10.1159/000052872
  23. Xiao W, Awadallah A, Xin W (2012). Loss of ARID1A/ BAF250a expression in ovarian endometriosis and clear cell carcinoma. Int J Clin Exp Pathol, 5, 642-50.