Nucleolus Scoring May Increase the Objectivity of Pathological Evaluation of Endometrial Cancers

Year 2023, Volume: 5 Issue: Supplement (1) - Innovations in Medicine and Healthcare in the 100th Year of the Republic, 53 - 9, 19.10.2023

Seda Duman Öztürk , Gökçe Aşkan , Çiğdem Öztürk , Oğuzhan Okcu , Bayram Şen , Recep Bedir

https://doi.org/10.37990/medr.1335060

Abstract

Aim: Nucleolus has been shown as a prognostic parameter in many cancer types. In this study, we showed that the nucleolus score may provide more objective FIGO grading in endometrial cancers (ECs). We examined the role of nucleolus score in predicting treatment and prognosis in ECs.
Material and Methods: The presence of nucleoli were scored as 1, 2 and 3 in curettage materials. The relationship between this value and clinicopathological parameters was examined.
Results: Nucleolus score was associated with FIGO grade, myometrial invasion and lymphovascular invasion. The nucleolus score, which has the potential for objective evaluation,was found as an independent risk factor for disease-free survival (DFS) as well as there was an association between nucleolus score and DFS.
Conclusion: Nucleolus score was associated with better prognosis in ECs. It can be evaluated objectively with no need of requiring extra cost and time. Thus, adding nucleolus score in FIGO grading can provide more reliable prediction in prognosis and choice of the treatment method.

Keywords

Endometrial carcinoma , nucleolus score , FIGO grade , prognosis.

References

• Hveem TS, Njølstad TS, Nielsen B, et al. Changes in chromatin structure in curettage specimens identifies high-risk patients in endometrial cancer. Cancer Epidemiol Biomarkers Prev. 2017;26:61-7.
• Lin Q, Ma X, Hu S, et al. Overexpression of nucleolusn is a potential prognostic marker in endometrial carcinoma. Cancer Manag Res. 2021;13:1955-65.
• Siegel RL, Miller KD, Goding Sauer A, et al. Colorectal cancer statistics, 2020. CA Cancer J Clin. 2020;70:145-64.
• Toptaş T, Peştereli E, Bozkurt S, S. et al . Relationships of nuclear, architectural and international Federation of gynecology and obstetrics grading systems in endometrial cancer. J Turk Ger Gynecol Assoc. 2018;19:17-22.
• Shepherd JH. Revised FIGO staging for gynaecological cancer. Br J Obstet Gynaecol 1989; 96: 889-92. Erratum in: Br J Obstet Gynaecol. 1992;99:440.
• Clarke BA, Gilks CB. Endometrial carcinoma: controversies in histopathological assessment of grade and tumour cell type. J Clin Pathol. 2010;63:410-5.
• Khatib G, Gulec UK, Guzel AB, et al. Prognosis trend of grade 2 endometrioid endometrial carcinoma: toward grade 1 or 3?. Pathol Oncol Res. 2020;26:2351-6.
• Zaino RJ, Silverberg SG, Norris HJ et al. The prognostic value of nuclear versus architectural grading in endometrial adenocarcinoma: a Gynecologic Oncology Group study. Int J Gynecol Pathol. 1994;13:29-36.
• Zaino RJ, Kurman RJ, Diana KL, et al. The utility of the revised International Federation of Gynecology and Obstetrics histologic grading of endometrial adenocarcinoma using a defined nuclear grading system. A Gynecologic Oncology Group study. Cancer. 1995;75:81-6.
• Alkushi A, Abdul-Rahman ZH, Lim P. et al Description of a novel system for grading of endometrial carcinoma and comparison with existing grading systems. Am J Surg Pathol. 2005;29:295-304.
• Pich A, Chiusa L, Margaria E. Prognostic relevance of agnors in tumor pathology. Micron. 2000;31:133-41.
• Elsharawy KA, Toss MS, Raafat S, et al. Prognostic significance of nucleolar assessment in invasive breast cancer. Histopathology. 2020;76:671-84.
• Helpap B, Knüpffer J, Essmann S. Nucleolar grading of renal cancer. Correlation of frequency and localization of nucleolus to histologic and cytologic grading and stage of renal cell carcinomas. Mod Pathol. 1990;3:671-8.
• Matias-Guiu X, Oliva E, McCluggage WG, et al. Tumours of the uterine corpus. In WHO Classification of Tumours Editorial Board. Female genital tumours. Lyon (France): International Agency for Research on Cancer; 2020 5th ed.; vol. 4.
• Sauerbrei W, Taube SE, McShane LM. et al. Reporting recommendations for tumormarker prognostic studies (REMARK): an abridged explanation and elaboration. J Natl Cancer Inst. 2018;110:803-11.
• Montanaro L, Treré D, Derenzini M. Nucleolus, ribosomes, and cancer. Am J Pathol. 2008;173:301-10.
• Elsharawy KA, Althobiti M, Mohammed OJ, et al. Nucleolar protein 10 (NOP10) predicts poor prognosis in invasive breast cancer. Breast Cancer Res Treat. 2021;185:615-27.
• Carotenuto P, Pecoraro A, Palma G, et al. Therapeutic approaches targeting nucleolus in cancer. Cells. 2019;8:1090.
• Stepinski D. The nucleolus, an ally, and an enemy of cancer cells. Histochem Cell Biol. 2018;150:607-29.
• Engbrecht M, Mangerich A. The nucleolus and PARP1 in cancer biology. Cancers. 2020;12:1813.
• Helpap B. Grading and prognostic significance of urologic carcinomas. Urologia Internationalis. 1992;48:245-57.
• Takeshima N, Hirai Y, Hasumi K. Prognostic validity of neoplastic cells with notable nuclear atypia in endometrial cancer. Obstet Gynecol. 1998;92:119-23.
• Ayhan A, Taskiran C, Yuce K, Kucukali T. The prognostic value of nuclear grading and the revised FIGO grading of endometrial adenocarcinoma. Int J Gynecol Pathol. 2003;22:71-4.
• Mariani A, Webb MJ, Keeney GL. et al Low-risk corpus cancer: is lymphadenectomy or radiotherapy necessary?. Am J Obstet Gynecol. 2000;182:1506-19.
• AlHilli MM, Podratz KC, Dowdy SC, et al. Preoperative biopsy and intraoperative tumor diameter predict lymph node dissemination in endometrial cancer. Gynecol Oncol. 2013;128:294-9.
• Vargas R, Rauh-Hain JA, Clemmer J, et al. Tumor size, depth of invasion, and histologic grade as prognostic factors of lymph node involvement in endometrial cancer: a SEER analysis. Gynecol Oncol. 2014;133:216-20.
• Courtney-Brooks M, Scalici JM, Tellawi AR. et al. Para-aortic lymph node dissection for women with endometrial adenocarcinoma and intermediate-to high-risk tumors: does it improve survival? Int J Gynecol Cancer. 2014;24:91-6.
• Kitchener H, Swart A, Qian Q, et al. Efficacy of systematic pelvic lymphadenectomy in endometrial cancer (MRC ASTEC trial): a randomised study. Lancet. 2009;373:125-36. Erratum in: Lancet. 2009;373:1764.
• Dowdy SC, Borah BJ, Bakkum-Gamez JN, A. et al. Prospective assessment of survival, morbidity, and cost associated with lymphadenectomy in low-risk endometrial cancer. Gynecol Oncol. 2012;127:5-10.
• Brooks RA, Fleming GF, Lastra RR, et al. Current recommendations and recent progress in endometrial cancer. CA Cancer J Clin. 2019;69:258-79.