title: High expression of SALL4 and fascin, and loss of E-cadherin expression in undifferentiated/dedifferentiated carcinomas of the endometrium: An immunohistochemical and clinicopathologic study.
abstract: Undifferentiated/dedifferentiated endometrial carcinomas (UCE/DCEs) of the endometrium are rare tumors with poor prognosis. There are few clinicopathologic studies with detailed immunohistochemical analysis regarding UCE/DCEs.We evaluated the diagnostic value of a selected tumor stem-cell marker and epithelial-mesenchymal transition (EMT) markers, in addition to previously studied markers in identifying UCE/DCEs from other types of high-grade endometrial carcinomas.Eleven cases of UCE/DCEs with complete clinical follow-up that were diagnosed between 2006 and 2015 were included in the study. For immunohistochemical comparison, 11 clinically matched cases for each type of other high-grade endometrial carcinomas (high-grade endometrioid (F3-EC), serous [SC], and clear cell carcinoma [CCC]) were used as a control group. An immunohistochemical analysis including fascin, SALL4, E-cadherin, and β-catenin, in addition to epithelial and neuroendocrine markers was performed in each case.The majority of UCE/DCEs displayed diffuse expression of fascin (81.9%) and loss of E-cadherin expression (54.5%). SALL4 expression was detected in 36.3% of the UCE/DCE cases. SALL4 expression was significantly more frequent in UCE/DCEs than all other high-grade carcinomas (P < 0.001). Loss of E-cadherin and fascin expression was significantly more frequent in UCE/DCEs than high-grade endometrioid and clear cell adenocarcinomas (P = 0.012, 0.014 and P = 0.01, 0.003, respectively).We suggest that loss of E-cadherin expression together with fascin and SALL4 immunopositivity in addition to morphologic features have an impact in differential diagnosis of UCE/DCEs from other high-grade endometrial carcinomas.
authors.affiliation: Department of Pathology, Istanbul Medical Faculty Department of Medical Oncology, Institute of Oncology, Istanbul University Department of Gynecologic Oncology, Istanbul Medical Faculty Department of Radiation Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey.
authors.forename: Semen
authors.initials: S
authors.lastname: Onder
authors.forename: Orhun Cig
authors.initials: OC
authors.lastname: Taskin
authors.forename: Fatma
authors.initials: F
authors.lastname: Sen
authors.forename: Samet
authors.initials: S
authors.lastname: Topuz
authors.forename: Seden
authors.initials: S
authors.lastname: Kucucuk
authors.forename: Hamdullah
authors.initials: H
authors.lastname: Sozen
authors.forename: Ridvan
authors.initials: R
authors.lastname: Ilhan
authors.forename: Sitki
authors.initials: S
authors.lastname: Tuzlali
authors.forename: Ekrem
authors.initials: E
authors.lastname: Yavuz
mesh_terms: D000368:Aged; D015820:Cadherins / Q000378:metabolism*; D002277:Carcinoma / Q000378:metabolism* / Q000473:pathology; D002352:Carrier Proteins / Q000378:metabolism*; D016889:Endometrial Neoplasms / Q000378:metabolism* / Q000473:pathology; D004717:Endometrium / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008840:Microfilament Proteins / Q000378:metabolism*; D008875:Middle Aged; D012189:Retrospective Studies; D014157:Transcription Factors / Q000378:metabolism*
chemical_list: D015820:Cadherins; D002352:Carrier Proteins; D008840:Microfilament Proteins; C472575:SALL4 protein, human; D014157:Transcription Factors; C020324:fascin