Biological behavior of grade II endometrial adenocarcinoma

Abstract EN

Background Endometrial adenocarcinoma grade II shares the same histological criteria, but have a heterogeneous biological behavior.

Identification of risk groups can improve management and fate. Aim Methods : this study included 40 paraffin embedded tumor blocks examined for DNA polity by Image Analysis (IA) and Flow Cytometry (FCM).

Proliferative activity was assessed by measuring Sphase fraction (SPF) by FCM and evaluating proliferative cell nuclear-associated antigen (PCNA) immunohistochemically. Results: Aneuploidy was found in 40% of cases by IA and in 25% of cases by FCM.

Although, both techniques were found reliable for policy analysis (p<0.001), yet IA was superior to FCM in detecting of aneuploidy.

A strong association was found between SPF and polity (p = 0.01).

Also, high PCNA expression was statistically significant with high SPF (P=0.05).

Moreover, PCNA correlates with polity by FCM (p=0.01) and IA (p<0.001).

By univariate analysis, polity (by IA or FCM), SPF and PCNA positive nuclear area showed a statistically significant correlation to survival. Conclusion : cases with aneuploid tumor and having high SPF are considered at high risk and cases with diploid tumor and having low SPF are considered at low risk, while cases with diploid tumor but having high SPF constitute the intermediate risk group.