A comparison of expression of ER, PR and p53 immunohistochemical stains between endometrial curetting/biopsy and resected endometrial carcinoma specimens

[摘要] Introduction and objective: The expression of immunohistochemical (IHC) stains is negatively affectedby poor fixation. Different markers behave variably under suboptimal pre-analytical conditions withcrucial diagnostic and therapeutic implications. The objective was to compare the expression ofoestrogen-receptor (ER), progesterone-receptor (PR) and p53 in curettings/ endometrial biopsies(C/EB) with the corresponding hysterectomy in endometrial carcinoma (EC).Method: Fifty cases of EC diagnosed by C/EB of which the resections received at the same centre,between 2017-2020 were retrieved from four tertiary care hospitals. IHC for ER, PR and p53 wereperformed on both C/EB and resection. Hormone-receptors (HR) were scored using Allred-score (ARS)(staining of >1% cells, ARS >3: positive). Strong nuclear staining in >80% or complete negative stainingwas considered mutant p53.Results: 47/50 (94%) showed concordance of histological typing between C/EB and resections[endometrioid - EC:35/36 (97.2%), serous - EC:11/12 (91.6%), clear cell carcinoma:0/1 (50%),carcinosarcoma:1/1 (100%)]. ER and PR were positive in 33/50 (66%), 32/50 (64%) C/EB and in 28/50(56%), 33/50 (66%) resections (ER, P=0.303; PR, P=0.209 >0.05), respectively. 46/50 (92%) showedconcordance between ER and PR expression. ARS for ER/PR in C/EB was higher than in resections in20 (40%) and 14 (28%) cases, respectively. The difference in ARS for ER between the two groups wasstatistically significant (ER, P=0.005; PR, P=0.133). The p53 expression pattern did not show asignificant difference between C/EB and resections (P=0.480).Discussion and conclusion: The under expression of HR in resections is best explained by poor fixation,although tumour heterogeneity may contribute. p53 expression appears to be unaffected. Immediateopening of the hysterectomy specimens allowing adequate fixation and preventing over fixation iscrucial in preventing the loss of hormone receptor expression.

[学科分类] 生理学与病理学