title: Patient age and biological aggressiveness of endometrial carcinoma.
abstract: BACKGROUND
  Advanced age is associated with a significantly worse prognosis of endometrial carcinoma patients. The aim of this study was to test whether age is a poor-risk factor in endometrial carcinoma because tumors arising in older patients are biologically different from those diagnosed in patients of an earlier age.
  
  
  METHODS
  Formalin-fixed, paraffin-embedded samples from 136 previously untreated patients with endometrial carcinoma were studied by means of immunohistochemistry. The expression of molecular markers associated with hormone responsiveness (estrogen and progesterone receptors), proliferation (Ki67, C-ERB-B2, p53), invasiveness (E-cadherin) and apoptosis (BCL2 and p53) was analyzed. The obtained expression levels, together with all available clinical and pathological features were tested for correlations with the patients age and survival.
  
  
  RESULTS
  Advanced patient age showed a direct correlation with tumor stage (r=0.29, p=0.0008) and mutant p53 expression (r=0.25, p=0.004), and an inverse correlation with E-cadherin expression (r=-0.28, p=0.001). Patient age above the 25th percentile (57 years) of the age distribution was significantly associated with a worse prognosis (p=0.018).
  
  
  CONCLUSIONS
  It appears that with advancing age, endometrial carcinoma exhibits a more aggressive tumor phenotype, characterized by mutant p53 expression and down-regulation of E-cadherin expression, and that this, in its turn, results in tumors being diagnosed at a more advanced stage in older patients.
authors.affiliation: Department of Pathology, Marqués de Valdecilla University Hospital, Cantabria University, Santander, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Gonzalez-Rodilla
authors.forename: M
authors.initials: M
authors.lastname: Boix
authors.forename: V
authors.initials: V
authors.lastname: Verna
authors.forename: A B
authors.initials: AB
authors.lastname: Muñoz
authors.forename: J
authors.initials: J
authors.lastname: Estévez
authors.forename: Y
authors.initials: Y
authors.lastname: Jubete
authors.forename: J
authors.initials: J
authors.lastname: Schneider
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015820:Cadherins / Q000032:analysis; D016889:Endometrial Neoplasms / Q000737:chemistry / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D016159:Tumor Suppressor Protein p53 / Q000032:analysis
chemical_list: D015820:Cadherins; D016159:Tumor Suppressor Protein p53