ENDOMETRİOİD ENDOMETRİAL KARSİNOMDA KLİNİKOPATOLOJİK ÖZELLİKLER İLE DNA UYUMSUZLUK ONARIMI PROTEİNLERİ VE P53 DURUMU ARASINDAKİ İLİŞKİ

Abstract

Amaç: Bu çalışmanın amacı, endometrioid endometrial karsinomda (EEK), geleneksel olarak prognostik klinikopatolojik özellikler ile immünohistokimyasal olarak değerlendirilen DNA Uyumsuzluk Onarımı (DUO) proteinleri ve p53 ekspresyonunun durumu arasındaki ilişkiyi değerlendirmektir. Material and Methods: A total of 142 EEC patients who underwent hysterectomy and lymph node resection between 2018 and 2024 were included. Immunohistochemical analysis was performed for MLH1, MSH2, MSH6, PMS2, and p53. Results: Our study showed that 66.2% of cases were MMR profi cient and 33.8% were MMR deficient (dMMR). dMMR cases were significantly associated with higher International Federation of Gynecology and Obstetric (FIGO) Grade 3 tumours (33.3% vs. 10.6%) and cervical stromal invasion (39.6% vs. 23.4%). However, no signif icant association was found between dMMR and other parameters such as tumour size or lymphovascular invasion. For p53, 11.3% of cases showed mutationtype staining, whereas 88.7% showed the wildtype. p53 mutationtype staining demonstrated significant associations with multiple aggressive clinicopathological features, such as age, FIGO grade, tumour size, myometrial invasion depth, lymphovascular invasion, and cervical stromal invasion. No case exhibited both p53 mutationtype staining and loss of MMR pro teins. Gereç ve Yöntemler: 20182024 yılları arasında histerektomi ve lenf nodu rezeksiyonu geçiren toplam 142 EEK hastası çalışmaya dahil edildi. MLH1, MSH2, MSH6, PMS2 ve p53 için immünohistokimyasal analiz yapıldı. Bulgular: Çalışmamız, vakaların %66,2'sinin DUOyeterli ve %33,8'inin DUOyetersiz (DUOy) olduğunu gösterdi. DUOy vakalar, Uluslararası Jinekoloji ve Obstetrik Federasyonu (UJOF) Grade 3 tümörler (%33,3'e karşı %10,6) ve servikal stromal invazyon varlığı (%39,6'ya karşı %23,4) ile önemli ölçüde ilişkiliydi. Ancak, DUOy ile tümör boyutu veya lenfovasküler invazyon gibi diğer parametreler arasında önemli bir ilişki bulunmadı. p53 immünhistokimyasal incelemesinde, vakaların %11,3'ü mutasyon tipi boyama gösterirken, %88,7'si olağan tip boyanma gösterdi. p53 mutasyon tipi boyama, yaş, UJOF derecesi, tümör boyutu, miyometriyal invazyon derinliği, lenfovasküler invazyon ve servikal stromal invazyon dahil olmak üzere birden fazla agresif klinikopatolojik özellik ile anlamlı ilişki gösterdi. Vakaların hiçbirinde eş zamanlı p53 mutasyon tipi boyama ve DUO proteinlerinin kaybı görülmedi. Sonuç: EEK'lerdeki MMR durumu ve p53 ekspresyonu, tümör UJOF derecesi ve servikal stromal invazyon gibi önemli klinikopatolojik özellikler ile belirgin şekilde ilişkilidir. p53 mutasyon tipi boyanmanın daha geniş bir agresif faktör yelpazesiyle ilişkisi, prognostik değerlendirme ve tedavi stratejileri için EEK heterojenliğini anlamada moleküler sınıflandırmanın önemini vurgulamaktadır.

Keywords

• Endometrioid karsinom
• MSI
• P53
• endometrium karsinomu

ASSOCIATION OF CLINICOPATHOLOGIC CHARACTERISTICS WITH MISMATCH REPAIR PROTEINS AND P53 IMMUNOHISTOCHEMISTRY FINDINGS IN ENDOMETRIOID ENDOMETRIAL CARCINOMA

Abstract

Objective: This study aimed to evaluate the relationship between traditional prognostic clinicopathological features and the status of immunohistochemically assessed mismatch repair (MMR) pro teins and p53 expression in endometrioid endometrial carcinoma (EEC). Material and Methods: A total of 142 EEC patients who underwent hysterectomy and lymph node resection between 2018 and 2024 were included. Immunohistochemical analysis was performed for MLH1, MSH2, MSH6, PMS2, and p53. Results: Our study showed that 66.2% of cases were MMR profi cient and 33.8% were MMR deficient (dMMR). dMMR cases were significantly associated with higher International Federation of Gynecology and Obstetric (FIGO) Grade 3 tumours (33.3% vs. 10.6%) and cervical stromal invasion (39.6% vs. 23.4%). However, no signif icant association was found between dMMR and other parameters such as tumour size or lymphovascular invasion. For p53, 11.3% of cases showed mutationtype staining, whereas 88.7% showed the wildtype. p53 mutationtype staining demonstrated significant associations with multiple aggressive clinicopathological features, such as age, FIGO grade, tumour size, myometrial invasion depth, lymphovascular invasion, and cervical stromal invasion. No case exhibited both p53 mutationtype staining and loss of MMR pro teins. Conclusion: MMR status and p53 expression in EECs are distinctly associated with key clinicopathological features, such as tumour FIGO grade and cervical stromal invasion. The association of the p53 mutation type with a broader range of aggressive factors underscores the importance of molecular classification in under standing EEC heterogeneity for prognostic evaluation and treat ment strategies.

Keywords

• Endometrioid carcinoma
• MSI
• P53
• endometrial carcinoma

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