Histopathological analysis of uterine corpus malignancies and the role of immunohistochemistry in distinction between endometrial adenocarcinoma and endocervical adenocarcinoma

Umadevi, Srinivasan (2016) Histopathological analysis of uterine corpus malignancies and the role of immunohistochemistry in distinction between endometrial adenocarcinoma and endocervical adenocarcinoma. Masters thesis, Thanjavur Medical College, Thanjavur.


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The study was carried out in Thanjavur Medical college and Hospital in Tamil Nadu over a period of three and half years. In a total of 7910 gynaecological specimens received, 761 cases (9.6%) were reported to be uterine corpus neoplasms including benign and malignant neoplasms. There are 60 malignant uterine corpus neoplasms reported out of 761 cases (7.8%). The following histopathological diagnosis were reported within this given period of time are 49 cases of endometrial carcinoma, 4 cases of leiomyosarcoma, 4 cases of choriocarcinoma, 1 case of endometrial stromal sarcoma, 1 case of germ cell tumors and 1 case of carcinosarcoma. The inference is that endometrial carcinoma is the most common malignancy observed in our study as seen in other literatures. In endometrial adenocarcinoma, Endometriod adenocarcinoma NOS type is the most common pattern noted. 76% of cases are exhibiting grade I features which is not in concordance with other studies, where Grade II features is prevalent. Around 80 % of tumors are Stage I tumors and hence simple hysterectomy is sufficient. Although stage II, III and higher grade tumors require Radical Hysterectomy with lymphadenectomy. The other histologic variants documented in our study are 1 case of uterine papillary serous carcinoma, 1 case of clear cell adenocarcinoma, 1 case of squamous cell carcinoma in an elderly women presenting with pyometra, and 2 cases of poorly differentiated carcinoma. The Immunohistochemical stains used in our study are ER and P16 . The expression of both the markers were studied in a total of 20 small biopsy / curettings which includes 10 cases of endometrial adenocarcinoma and 10 cases of endocervical adenocarcinoma. 90% of endocervical adenocarcinoma expressed P16 and 40% of endometrial adenocarcinoma expressed P16. ER expression was 60% in endometrial adenocarcinoma and 30 % in endocervical adenocarcinoma.Both markers were positive in 30% of cases and no single marker is diagnostic to distinguish endometrial adenocarcinoma from endocervical adenocarcinoma. Various literatures rtecomment panel of IHC markers to distinguish this two. The panel should include ER, PR, Vimentin, CEA, P16. ER, PR, and vimentin is predominantly positive in Endometrial adenocarcinomas whereas CEAand P16 is positive in Endocervical adenocarcinomas. Recent studies have shown that Conventional three panel markers ER/Vimentin/CEA panel is sufficient, appropriate and useful. Ancillary PR and P16 INK 4a add no value to the performance of the conventional three marker ER/Vimentin/CEA panel.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Uterine corpus malignancies ; Endometrial carcinoma ; Immunohistochemistry ER ; P16.
Subjects: MEDICAL > Pathology
Depositing User: Punitha K
Date Deposited: 10 Jul 2017 09:20
Last Modified: 26 Nov 2018 17:26
URI: http://repository-tnmgrmu.ac.in/id/eprint/1295

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