Nuclear grading of endometrial cancer harbors heterogenous prognostic groups as detected by proliferation activity.
OBJECTIVE
Nuclear grading, in addition to the histopathological result of every tumor, is responsible for consecutive treatment designs. Ki-S5 is the monoclonal antibody against a formalin-resistant epitope of the Ki-67 antigen and can be determined in paraffin-embedded samples. The aim of the study was a comparative analysis of the nuclear grading of endometrial cancer and the proliferation marker Ki-S5.


METHODS
In 126 specimens of endometrial cancer the proliferation activity of the monoclonal antibody Ki-S5 was determined (streptavidin-biotin-complex method) in correlation to nuclear grading. In the group of grade 2, stages Ib and Ic andenocarcinomas, proliferation rates were compared to recurrence rates.


RESULTS
Divergent proliferation rates resulted. Adenoacanthomas showed a relatively low proliferation rate (<28%). For the andenosquamous carcinomas the proliferation rate ranged between 28-43%. The largest group of adenocarcinomas showed proliferation rates from 5-74%. A clear dependency between increasing proliferation rates and decreasing differentiation (nuclear grading 2-3) was observed. In the small group of patients with andenocarcinomas, nuclear grading G2 stages Ib and Ic, 38 suffered no recurrence after 6-10 years. However, the six patients with proliferation rates of over 35% all suffered a recurrence.


CONCLUSIONS
The results emphasize the need to differentiate G2 tumors, depending on their proliferation rate, into low risk (KiS5<35%) and high risk cases (Ki-S5>35%).
Mettler
L
L
Department of Obstetrics & Gynaecology, University of Kiel, Germany.
Völckers
S
S
Bidzinski
M
M
D000230:Adenocarcinoma / Q000276:immunology / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000276:immunology; D018196:Carcinoma, Adenosquamous / Q000276:immunology / Q000473:pathology / Q000601:surgery; D002455:Cell Division / Q000502:physiology; D002467:Cell Nucleus / Q000473:pathology*; D016889:Endometrial Neoplasms / Q000276:immunology / Q000473:pathology* / Q000601:surgery; D000939:Epitopes / Q000032:analysis / Q000276:immunology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000276:immunology; D008679:Metaplasia / Q000276:immunology / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D016612:Paraffin Embedding; D011379:Prognosis
D000911:Antibodies, Monoclonal; D000939:Epitopes; D019394:Ki-67 Antigen