Poly(adenosine diphosphate-ribose) polymerase expression in serous ovarian carcinoma: correlation with p53, MIB-1, and outcome

Hermann Brustmann, Nadia Ismiil, Nadia D Ismiil, Ismiil ND, Golnar Rasty, Rasty G, Zeina Ghorab, Ghorab Z, Sharon Nofech-Mozes, Nofech-Mozes S, Sharon Nofech‐Mozes, Bernardini M, Marcus Bernardini, Marcus Q. Bernardini, Thomas G, Gillian Thomas, Ackerman I, Ida Ackerman, Covens A, Allan Covens, Mahmoud A. Khalifa, Khalifa MA
International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists · 2007 · vol. 26(3) , pp. 278–283 · doi:10.1097/01.pgp.0000235064.93182.ec · PMID:17413981 · W2067749807
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FIGO grade 1 endometrial endometrioid adenocarcinoma involving adenomyosis demonstrates a significantly higher rate of myometrial invasion compared to tumors occurring without adenomyosis.

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This retrospective study examined whether the presence of adenomyosis influences the risk of myometrial invasion in patients with FIGO grade 1 endometrioid adenocarcinoma. Researchers analyzed hysterectomy specimens from 46 cases with cancer-positive adenomyosis and 49 cases without adenomyosis, utilizing CD10 staining to confirm invasion patterns. The findings revealed that myometrial invasion occurred significantly more frequently in the adenomyosis group (91.3%) compared to those without the condition (77.5%), suggesting that coexistent adenomyosis may increase the tumor's interface with the myometrium and facilitate deeper penetration. This paper is centrally about adenomyosis — specifically its association with increased myometrial invasion risk in early-stage endometrial cancer.

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Abstract

This study investigated the expression of poly(adenosine diphosphate-ribose) polymerase (PARP) in a cohort of ovarian serous carcinomas by immunohistochemistry with regard to outcome, clinicopathologic parameters, proliferation as assessed by MIB-1 labeling indices (LIs), and p53 immunoexpression. Formalin-fixed, paraffin-embedded archival tissues of 50 ovarian serous carcinomas were immunostained with antibodies to PARP, MIB-1, and p53. In addition, 10 benign serous cystadenomas and 10 typical serous borderline ovarian tumors were included in the PARP immunostudy. Immunostaining for PARP was scored with regard to quantity and intensity of positively stained nuclei as negative, low, or strong. The MIB-1 LIs were quantitated as the percentage of positively stained nuclei in 1000 nuclei. For p53, at least 10% of tumor cells had to display nuclear staining. The expression of PARP was scored negative in all serous cystadenomas and low in serous borderline ovarian tumors. Strong PARP expression was determined in 38 cases (76%), and low expression in 12 cases (12%) of ovarian serous carcinomas; MIB-1 staining was noted in all cases (mean, 44.2; range, 10.8-66.5), positivity for p53 in 39 cases (78%). The PARP immunoreactivity increased with the International Federation of Gynecology and Obstetrics stage (P = 0.0075), as well as p53 positivity (P = 0.0141) and MIB-1 LIs (P = 0.0102), with grade determined after Malpica et al. (P = 0.0445) but not with grade assessed after Shimizu et al. (P = 0.1495). A trend for poor outcome was observed in patients whose tumors displayed high levels of PARP immunoexpression (P = 0.0196, log-rank test). This study indicates that PARP expression is frequently upregulated in ovarian serous carcinomas, related with MIB-1 LIs and p53 expression, and may serve as a marker of aggressive behavior with prognostic value.
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Adenomyosis is Associated With Myometrial Invasion by FIGO 1 Endometrial Adenocarcinoma - Nadia D. Ismiil - Golnar Rasty - Zeina Ghorab - Sharon Nofech-Mozes - Marcus Bernardini - Gillian Thomas - Ida Ackerman - Allan Covens - Mahmoud A. Khalifa Summary: Adenomyosis is commonly seen in hysterectomy specimens for endometrial adenocarcinoma where it could be involved with the tumor. When adenocarcinoma involves adenomyosis, the tumor may remain limited to the adenomyosis or proceeds to invade the adjacent myometrium. The purpose of this study was to investigate whether the risk of myometrial invasion by grade 1 endometrioid adenocarcinoma in cases with cancer-positive adenomyosis is different from that of cases where cancer occurs in the absence of adenomyosis. Forty-six consecutive hysterectomy specimens with International Federation of Gynecology and Obstetrics (FIGO) grade 1 endometrial endometrioid adenocarcinoma involving adenomyosis and 49 consecutive specimens with the same tumor occurring in the absence of adenomyosis were retrospectively studied by 4 experienced gynecologic pathologists. In cases with adenomyosis, myometrial invasion was confirmed by CD10-negative staining around glands with irregular outline surrounded by inflamed desmoplastic stroma. Myometrial invasion was found in significantly more adenomyosis cases (n = 42, 91.3%) than in cases without adenomyosis (n = 38, 77.5%) (χ2 = 4.79, P = 0.03). In 16 cases of the former group, the invasion only occurred from the foci of adenomyosis. Although myometrial invasion in the outer half was more common in the adenomyosis group (n = 16, 34.8%) than in cases without adenomyosis (n = 9, 18.4%), the difference was not statistically significant (χ2 = 3.29, P = 0.07). By involving coexistent adenomyosis, FIGO grade 1 endometrial endometrioid adenocarcinoma is associated with myometrial invasion, probably through increasing the surface area of its interface with the adjacent myometrium. When compared with their counterparts that occur in the absence of adenomyosis, these tumors are significantly more likely to invade the myometrium.

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Adenocarcinoma Cystadenoma, Serous Endometrial Neoplasms Endometriosis Ki-67 Antigen Myometrium Ovarian Neoplasms Poly(ADP-ribose) Polymerases Tumor Suppressor Protein p53 Adenocarcinoma Adenocarcinoma Adenocarcinoma Adult Adult Aged Aged Aged, 80 and over Aged, 80 and over Apoptosis Cell Proliferation

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