Inter‑component immunohistochemical assessment of proliferative markers in uterine carcinosarcoma

Pyra,Andrzej; Adamiak‑Godlewska,Aneta; Lewkowicz,Dorota; Bałon,Beata; Cybulski,Marek; Semczuk‑Sikora,Anna; Semczuk,Andrzej

doi:10.3892/ol.2022.13483

Inter‑component immunohistochemical assessment of proliferative markers in uterine carcinosarcoma

Authors:
- Andrzej Pyra
- Aneta Adamiak‑Godlewska
- Dorota Lewkowicz
- Beata Bałon
- Marek Cybulski
- Anna Semczuk‑Sikora
- Andrzej Semczuk
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Affiliations: Department of Gynecology and Obstetrics, Municipal Hospital, PL‑39460 Nowa Dęba, Poland, Second Department of Gynecology, Lublin Medical University, PL‑20954 Lublin, Poland, Department of Clinical Pathology, Lublin Medical University, PL‑20954 Lublin, Poland, Medical Institute, State School, PL‑38500 Sanok, Poland, Department of Biochemistry and Molecular Biology, Lublin Medical University, PL-20093 Lublin, Poland, Department of Obstetrics and Pathology of Pregnancy, Lublin Medical University, PL‑20081 Lublin, Poland
Published online on: August 31, 2022 https://doi.org/10.3892/ol.2022.13483
Article Number: 363
Copyright: © Pyra et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

In the scientific literature, a selected number of reports have investigated the impact of proliferative activity on the development and progression of uterine carcinosarcomas (UC). The aim of the present retrospective study was to compare the immunohistochemical proliferation markers [Ki67, proliferating cell nuclear antigen (PCNA), minichromosome maintenance complex component 3 (MCM3), and topoisomerase IIα (topoIIα)] assessment in both components of UC. A total of 30 paraffin‑embedded slides of UCs, obtained from patients who underwent surgery between January 1, 2006, and December 31, 2020, were analyzed. Medical records and clinicopathological data of patients were reviewed. Formalin‑fixed, paraffin‑embedded tissue sections were immunostained with monoclonal antibodies against Ki67, PCNA, MCM3 and topoIIα. Ki67‑positive nuclear immunoreactivity was reported in 20 (67%) and 16 (53%) UC carcinomatous and sarcomatous components, respectively. In the epithelial component, Ki67 positive staining was related to the International Federation of Gynecology and Obstetrics (FIGO) stage (P=0.025), and histological grade (G1 vs. G2/G3, P=0.031). Nuclear PCNA reactivity was observed in 18 (60%) and 16 (53%) carcinomatous and sarcomatous components, respectively. Notably, all four cases with omental metastases were PCNA‑positive, and a relationship between staining pattern and the existence of metastases was of significant value (P=0.018). MCM3‑positive nuclear staining was found nearly twice as high in the carcinomatous (n=19; 63%), compared with the sarcomatous (n=11; 37%) component, respectively, and MCM3 expression in the epithelial component was related to clinical stage (P=0.030), and the existence of omental metastasis (P=0.012). In addition, out of the 30 UCs, 17 (57%) and 13 (43%) showed topoIIα positivity in the carcinomatous and sarcomatous UC components, respectively. A significant relationship between protein immunoreactivity and FIGO stage (P=0.049), and omental metastasis (P=0.026) was revealed to exist. However, no significant differences between expression of proliferation markers and clinicopathological features in the sarcomatous UC component were identified. Finally, a significant correlation between each protein immunohistochemical staining was demonstrated, particularly in the sarcomatous UC component. Collectively, a combined analysis of Ki67, PCNA, MCM3, and topoIIα may provide more detailed information of cell‑cycle alterations determining the heterogeneity of uterine carcinosarcomas.

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