{"paper_id":"84e27f8e-2c2d-48ee-b36b-4bbb76b57041","body_text":"Abstract\nIn endometrial endometrioid adenocarcinoma (EEC), the depth of myometrial invasion (MI) is an important parameter for determining whether additional treatment is warranted. The present study investigated the association between MI patterns, cancer stem cell (CSC) phenotypes, and their clinicopathological significance in EEC. A total of 73 cases of EEC with MI were examined in this study. Haematoxylin and eosin-stained tissue specimens were analysed for MI pattern, which was categorised as infiltrating; expansile; adenomyosis (AM)-like; or microcystic, elongated, and fragmented (MELF)-type. The expression of CSC markers such as cluster of differentiation (CD)44, CD133, and Nanog1, as well as oestrogen receptor (ER) and progesterone receptor (PR) was examined by immunohistochemistry. Clinicopathological features including age, DOI, MI pattern, LVI, lymph node (LN) metastasis, disease progression, and survival outcome were recorded. Most examined cases (45/73) were International Federation of Gynecology and Obstetrics (FIGO) stage I. MI showed infiltrating (49.3%), AM-like (26.3%), MELF (15.1%), and expansile (9.6%) patterns. Tumours with the infiltrating pattern were associated with high FIGO grade (P = 0.002), reduced ER and PR, and CD44 expression (P = 0.014, 0.026, and 0.030, respectively); those with a MELF pattern showed LN metastasis (P < 0.001), lymphovascular invasion (P = 0.011), and reduced ER, CD44, and CD133 expression (P = 0.036, 0.006, and 0.016, respectively). EEC with infiltrating/MELF patterns of MI is associated with worse prognosis. These results suggest that CSC expression profiles are an unfavourable indicator of EEC.\nAccess this article\nWe’re sorry, something doesn't seem to be working properly.\nPlease try refreshing the page. If that doesn't work, please contact support so we can address the problem.\nSimilar content being viewed by others\nAbbreviations\n- AM:\n-\nadenomyosis\n- CD:\n-\ncluster of differentiation\n- EEC:\n-\nendometrial endometrioid carcinoma\n- ER:\n-\noestrogen receptor\n- CSC:\n-\ncancer stem cells\n- DOI:\n-\ndepth of invasion\n- EMT:\n-\nepithelial-mesenchymal transition\n- FIGO:\n-\nInternational Federation of Gynecology and Obstetrics\n- LN:\n-\nlymph node.\n- LNI:\n-\nlymph node involvement.\n- LUS:\n-\nlower uterine segment.\n- LVI:\n-\nlymphovascular invasion.\n- MELF:\n-\nmicrocystic, elongated, and fragmented.\n- MI:\n-\nmyometrial invasion.\n- PR:\n-\nprogesterone receptor.\nReferences\nCole AJ, Quick CM (2013) Patterns of myoinvasion in endometrial adenocarcinoma: recognition and implications. 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Association between Morphological Patterns of Myometrial Invasion and Cancer Stem Cell Markers in Endometrial Endometrioid Carcinoma. Pathol. Oncol. Res. 25, 123–130 (2019). https://doi.org/10.1007/s12253-017-0320-5\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s12253-017-0320-5","source_license":"public-domain-us","license_restricted":false}