Mesonephric-like Adenocarcinoma of the Uterine Corpus: Comprehensive Immunohistochemical Analyses Using Markers for Mesonephric, Endometrioid and Serous Tumors
Abstract
:1. Introduction
2. Materials and Methods
2.1. Case Selection
2.2. IHC
2.3. IHC Interpretation
2.4. FISH
2.5. Statistical Analysis
2.6. NGS
3. Results
3.1. Clinicopathological Characteristics
3.2. Histological Features and Immunophenotype of Mesonephric-like Carcinosarcoma (MLCS)
3.3. IHC Results
3.3.1. ER and PR
3.3.2. GATA3
3.3.3. p16 and p53
3.3.4. HER2
3.3.5. TTF1
3.3.6. CD10
3.4. NGS Results
3.5. Results of Statistical Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Antibody | Clone | Company | Dilution |
---|---|---|---|
GATA3 | L50-823 | Ventana Medical Systems (Roche, Oro Valley, AZ, USA) | Prediluted |
TTF1 | 8G7G3/1 | Dako (Agilent Technologies, Santa Clara, CA, USA) | 1:100 |
CD10 | 56C6 | Novocastra (Leica Biosystems, Buffalo Grove, IL, USA) | 1:100 |
ER | 6F11 | Novocastra (Leica Biosystems, Buffalo Grove, IL, USA) | 1:200 |
PR | 16 | Novocastra (Leica Biosystems, Buffalo Grove, IL, USA) | 1:800 |
p53 | DO-7 | Novocastra (Leica Biosystems, Buffalo Grove, IL, USA) | 1:200 |
p16 | E6H4 | Ventana Medical Systems (Roche, Oro Valley, AZ, USA) | Prediluted |
HER2 | 4B5 | Ventana Medical Systems (Roche, Oro Valley, AZ, USA) | Prediluted |
Case No. | Age (Years) | Initial FIGO Stage | Recurrence | Lung Metastasis | DFS (Months) |
---|---|---|---|---|---|
1 | 50 | IA | Yes | Yes | 53 |
2 | 62 | IA | Yes | Yes | 60 |
3 | 62 | IIIC2 | Yes | Yes | 33 |
4 | 53 | IIIA | Yes | No | 55 |
5 | 67 | IIIC2 | Yes | No | 12 |
6 | 47 | IVB | Yes | No | 5 |
7 | 59 | IIIC1 | NA (recent) | NA (recent) | NA (recent) |
8 | 48 | IIIC1 | Yes | No | 20 |
9 | 72 | IA | Yes | Yes | 22 |
10 | 58 | IIIB | No | No | 19 |
11 | 59 | IIIC1 | Yes | Yes | 15 |
12 | 52 | IIIB | No | No | 15 |
13 | 56 | IIIB | No | No | 12 |
14 | 66 | IB | No | No | 11 |
15 | 68 | IVB | Yes | Yes | 8 |
16 | 57 | IVB | Yes | No | 4 |
17 | 77 | IA | NA (recent) | NA (recent) | NA (recent) |
18 | 55 | II | Yes | Yes | 26 |
19 | 69 | IVB | No | Yes | 36 |
20 | 61 | IB | Yes | Yes | 5 |
21 | 62 | IVB | Yes | Yes | 16 |
22 | 43 | II | Yes | Yes | 39 |
23 | 46 | IIIC1 | Yes | Yes | 6 |
24 | 60 | IB | Yes | Yes | 15 |
25 | 61 | IVB | Yes | Yes | 13 |
Case No. | GATA3 | ER | PR | p16 | p53 | TTF1 | CD10 | HER2 IHC | HER2 FISH | KRAS | ||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
S (%) | M (%) | W (%) | N (%) | H | S (%) | M (%) | W (%) | N (%) | H | S (%) | M (%) | W (%) | N (%) | H | S (%) | M (%) | W (%) | N (%) | H | S (%) | M (%) | W (%) | N (%) | H | ||||||
1 | 0 | 40 | 30 | 30 | 110 | 0 | 0 | 0 | 100 | 0 | 10 | 30 | 0 | 60 | 90 | WT | P | 0 | 5 | 0 | 95 | 10 | 5 | 5 | 0 | 90 | 25 | 1+ | p.G12D | |
2 | 0 | 5 | 5 | 90 | 15 | 0 | 0 | 1 | 99 | 1 | 0 | 0 | 1 | 99 | 1 | WT | P | 0 | 5 | 0 | 95 | 10 | 0 | 0 | 0 | 100 | 0 | 0 | WT | |
3 | 5 | 5 | 0 | 90 | 25 | 10 | 20 | 10 | 60 | 80 | 0 | 0 | 0 | 100 | 0 | WT | P | 80 | 0 | 0 | 20 | 240 | 10 | 0 | 0 | 90 | 30 | 0 | p.G12D | |
4 | 80 | 10 | 0 | 10 | 260 | 10 | 20 | 20 | 50 | 90 | 0 | 0 | 0 | 100 | 0 | WT | P | 0 | 40 | 30 | 30 | 110 | 20 | 0 | 0 | 80 | 60 | 1+ | WT | |
5 | 80 | 10 | 0 | 10 | 260 | 0 | 10 | 10 | 80 | 30 | 0 | 0 | 0 | 100 | 0 | WT | N | 80 | 0 | 0 | 20 | 240 | 50 | 0 | 0 | 50 | 150 | 1+ | p.G12D | |
6 | 10 | 20 | 20 | 50 | 90 | 0 | 0 | 5 | 95 | 5 | 0 | 0 | 0 | 100 | 0 | WT | P | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | 0 | NA | |
7 | 0 | 5 | 5 | 90 | 15 | 0 | 0 | 0 | 100 | 0 | 0 | 0 | 0 | 100 | 0 | WT | P | 30 | 20 | 0 | 50 | 130 | 5 | 0 | 0 | 95 | 15 | 0 | p.G12V | |
8 | 10 | 30 | 0 | 60 | 90 | 0 | 0 | 0 | 100 | 0 | 0 | 0 | 0 | 100 | 0 | WT | N | 60 | 0 | 0 | 40 | 180 | 30 | 20 | 0 | 50 | 130 | 0 | p.G12D | |
9 | 0 | 5 | 0 | 95 | 10 | 0 | 1 | 4 | 95 | 6 | 0 | 0 | 0 | 100 | 0 | WT | P | 100 | 0 | 0 | 0 | 300 | 50 | 0 | 0 | 50 | 150 | 2+ | N | p.G12V |
10 | 15 | 60 | 10 | 15 | 175 | 0 | 0 | 0 | 100 | 0 | 0 | 0 | 0 | 100 | 0 | WT | P | 50 | 0 | 0 | 50 | 150 | 30 | 20 | 0 | 50 | 130 | 0 | p.G12D | |
11 | 20 | 20 | 0 | 60 | 100 | 0 | 0 | 0 | 100 | 0 | 0 | 0 | 0 | 100 | 0 | WT | P | 40 | 0 | 0 | 60 | 120 | 20 | 20 | 0 | 60 | 100 | 1+ | p.G12C | |
12 | 20 | 60 | 10 | 10 | 190 | 0 | 0 | 0 | 100 | 0 | 0 | 0 | 0 | 100 | 0 | WT | P | 0 | 30 | 0 | 70 | 60 | 0 | 0 | 0 | 100 | 0 | 1+ | WT | |
13 | 1 | 2 | 2 | 95 | 9 | 0 | 0 | 1 | 99 | 1 | 0 | 0 | 0 | 100 | 0 | WT | P | 0 | 0 | 10 | 90 | 10 | 50 | 10 | 0 | 40 | 170 | 0 | WT | |
14 | 90 | 5 | 0 | 5 | 280 | 15 | 10 | 0 | 75 | 65 | 4 | 1 | 0 | 95 | 14 | WT | P | 5 | 0 | 0 | 95 | 15 | 0 | 0 | 0 | 100 | 0 | 2+ | N | WT |
15 | 10 | 20 | 50 | 20 | 120 | 0 | 0 | 0 | 100 | 0 | 0 | 0 | 0 | 100 | 0 | WT | P | 100 | 0 | 0 | 0 | 300 | 100 | 0 | 0 | 0 | 300 | 1+ | p.G12D | |
16 | 80 | 5 | 0 | 15 | 250 | 0 | 0 | 0 | 100 | 0 | 0 | 0 | 0 | 100 | 0 | WT | P | 0 | 25 | 0 | 75 | 40 | 60 | 10 | 0 | 50 | 200 | 1+ | p.G12V | |
17 | 10 | 15 | 15 | 60 | 75 | 0 | 0 | 0 | 100 | 0 | 0 | 0 | 0 | 100 | 0 | WT | P | 100 | 0 | 0 | 0 | 300 | 50 | 20 | 0 | 30 | 190 | 1+ | p.G12V | |
18 | 0 | 0 | 0 | 100 | 0 | 0 | 0 | 0 | 100 | 0 | 0 | 0 | 0 | 100 | 0 | WT | P | 0 | 0 | 10 | 90 | 10 | 90 | 0 | 0 | 10 | 270 | 2+ | N | p.G12V |
19 | 100 | 0 | 0 | 0 | 300 | 0 | 0 | 0 | 100 | 0 | 0 | 0 | 0 | 100 | 0 | WT | P | 0 | 0 | 5 | 95 | 5 | 10 | 10 | 0 | 80 | 50 | 0 | p.G12D | |
20 | 0 | 5 | 5 | 90 | 15 | 0 | 0 | 0 | 100 | 0 | 0 | 0 | 0 | 100 | 0 | WT | P | 20 | 20 | 0 | 60 | 100 | 5 | 0 | 0 | 95 | 15 | 2+ | N | p.G12V |
21 | 90 | 5 | 5 | 0 | 285 | 0 | 0 | 0 | 100 | 0 | 0 | 0 | 0 | 100 | 0 | WT | P | 0 | 0 | 10 | 90 | 10 | 0 | 0 | 0 | 100 | 0 | 2+ | N | p.G13D |
22 | 0 | 0 | 0 | 100 | 0 | 0 | 0 | 0 | 100 | 0 | 0 | 0 | 0 | 100 | 0 | WT | P | 0 | 5 | 0 | 95 | 10 | 20 | 10 | 0 | 70 | 80 | 0 | p.G12D | |
23 | 10 | 20 | 10 | 60 | 80 | 0 | 0 | 0 | 100 | 0 | 0 | 0 | 0 | 100 | 0 | WT | P | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | 0 | NA | |
24 | 10 | 20 | 0 | 70 | 70 | 0 | 0 | 0 | 100 | 0 | 0 | 0 | 0 | 100 | 0 | WT | P | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | 1+ | NA | |
25 | 15 | 10 | 15 | 60 | 80 | 0 | 0 | 0 | 100 | 0 | 0 | 0 | 0 | 100 | 0 | WT | P | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | 0 | NA |
Antibody | Intensity | Proportion (%) | Patients (%) |
---|---|---|---|
GATA3 | Moderate-to-strong | ≥75 | 8 (32.0) |
Moderate-to-strong | 25–49 | 9 (36.0) | |
Negative | ≥90 | 8 (32.0) | |
ER | Moderate-to-strong | 25–49 | 3 (12.0) |
Weak-to-moderate | 5–24 | 3 (12.0) | |
Negative | ≥99 | 19 (76.0) | |
PR | Moderate-to-strong | 5–49 | 2 (8.0) |
Negative | ≥99 | 23 (88.0) | |
p53 | Wild-type | 25 (100.0) | |
p16 | Patchy | 23 (92.0) | |
Negative | 2 (8.0) | ||
TTF1 | Moderate-to-strong | ≥50 | 8 (32.0) |
Moderate-to-strong | 25–49 | 5 (20.0) | |
Negative | ≥90 | 8 (32.0) | |
Not applicable | 4 (16.0) | ||
CD10 | Moderate-to-strong | ≥50 | 9 (36.0) |
Moderate-to-strong | 5–49 | 8 (32.0) | |
Negative | ≥99 | 4 (20.0) | |
Not applicable | 4 (16.0) | ||
HER2 | Negative (0–1+) | 20 (80.0) | |
Equivocal (2+) | 5 (20.0) |
Parameter | Total (%) | GATA3 | ER | PR | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|
H < 50 | H ≥50 | p Value | H < 5 | H ≥ 5 | p Value | H < 5 | H ≥ 5 | p Value | |||
Initial FIGO stage | I | 7 (28.0) | 3 (42.9) | 4 (57.1) | 0.640 | 5 (71.4) | 2 (28.6) | 1.000 | 5 (71.4) | 2 (28.6) | 0.070 |
II–IV | 18 (72.0) | 5 (27.8) | 13 (72.2) | 14 (77.8) | 4 (22.2) | 18 (100.0) | 0 (0.0) | ||||
Recurrence | No | 5 (20.0) | 1 (20.0) | 4 (80.0) | 1.000 | 4 (80.0) | 1 (20.0) | 1.000 | 4 (80.0) | 1 (20.0) | 0.395 |
Yes | 18 (72.0) | 6 (33.3) | 12 (66.7) | 13 (72.2) | 5 (27.8) | 17 (94.4) | 1 (5.6) | ||||
NA | 2 (8.0) | ||||||||||
Lung metastasis | No | 9 (36.0) | 1 (11.1) | 8 (88.9) | 0.176 | 5 (55.6) | 4 (44.4) | 0.162 | 8 (88.9) | 1 (11.1) | 1.000 |
Yes | 14 (56.0) | 6 (42.9) | 8 (57.1) | 12 (85.7) | 2 (14.3) | 13 (92.9) | 1 (7.1) | ||||
NA | 2 (8.0) | ||||||||||
Mean DFS (months) | 31.6 | 22.8 | 0.237 | 24.8 | 26.3 | 0.972 | 23.4 | 53.0 | 0.384 |
Parameter | Total (%) | TTF1 | CD10 | |||||
---|---|---|---|---|---|---|---|---|
H < 50 | H ≥ 50 | p Value | H < 50 | H ≥ 50 | p Value | |||
Initial FIGO stage | I | 6 (28.6) | 3 (50.0) | 3 (50.0) | 1.000 | 4 (66.7) | 2 (33.3) | 0.146 |
II–IV | 15 (71.4) | 6 (40.0) | 9 (60.0) | 4 (26.7) | 11 (73.3) | |||
Recurrence | No | 5 (23.8) | 3 (60.0) | 2 (40.0) | 0.628 | 2 (40.0) | 3 (60.0) | 1.000 |
Yes | 14 (66.7) | 6 (42.9) | 8 (57.1) | 5 (35.7) | 9 (64.3) | |||
NA | 2 (9.5) | |||||||
Lung metastasis | No | 8 (38.1) | 3 (37.5) | 5 (62.5) | 0.650 | 2 (25.0) | 6 (75.0) | 0.633 |
Yes | 11 (52.4) | 6 (54.5) | 5 (45.5) | 5 (45.5) | 6 (54.5) | |||
NA | 2 (9.5) | |||||||
Mean DFS (months) | 34.5 | 23.5 | 0.233 | 35.4 | 25.1 | 0.297 |
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Kim, H.; Na, K.; Bae, G.E.; Kim, H.-S. Mesonephric-like Adenocarcinoma of the Uterine Corpus: Comprehensive Immunohistochemical Analyses Using Markers for Mesonephric, Endometrioid and Serous Tumors. Diagnostics 2021, 11, 2042. https://doi.org/10.3390/diagnostics11112042
Kim H, Na K, Bae GE, Kim H-S. Mesonephric-like Adenocarcinoma of the Uterine Corpus: Comprehensive Immunohistochemical Analyses Using Markers for Mesonephric, Endometrioid and Serous Tumors. Diagnostics. 2021; 11(11):2042. https://doi.org/10.3390/diagnostics11112042
Chicago/Turabian StyleKim, Hyunjin, Kiyong Na, Go Eun Bae, and Hyun-Soo Kim. 2021. "Mesonephric-like Adenocarcinoma of the Uterine Corpus: Comprehensive Immunohistochemical Analyses Using Markers for Mesonephric, Endometrioid and Serous Tumors" Diagnostics 11, no. 11: 2042. https://doi.org/10.3390/diagnostics11112042