ArticleThe American journal of surgical pathology2020
Endometrial Carcinomas with a "Serous" Component in Young Women Are Enriched for DNA Mismatch Repair Deficiency, Lynch Syndrome, and POLE Exonuclease Domain Mutations.
Article in The American journal of surgical pathology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it, 57 citations in OpenAlex.
- Pooled it
- Prognostic significance of CTNNB1 mutation in early stage endometrial carcinoma: a systematic review and meta-analysis.Archives of gynecology and obstetrics · 2022Pooled it
- Prognostic value of the TCGA molecular classification in uterine carcinosarcoma.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2022Pooled it
- Prevalence of Mismatch Repair Deficiency and Its Association with Histopathological Parameters in Endometrial Cancer: A Prospective Cohort Study.International journal of molecular sciences · 2026Article
- Prognostic Implications of Combined p53 and Mismatch-Repair Immunophenotypes in Uterine Carcinosarcoma.Medicina (Kaunas, Lithuania) · 2026Article
- Article
- Article
- Review
- New clinicopathological concept of endometrial carcinoma with integration of histological features and molecular profiles.Pathology international · 2024Review
- Unsolved Issues in the Integrated Histo-Molecular Classification of Endometrial Carcinoma and Therapeutic Implications.Cancers · 2024Review
- Clinical features and impact of p53 status on sporadic mismatch repair deficiency and Lynch syndrome in uterine cancer.Cancer science · 2024Article
- Molecular Characterization of Endometrial Carcinomas in Black and White Patients Reveals Disparate Drivers with Therapeutic Implications.Cancer discovery · 2023Article
- Corded and hyalinized endometrioid endometrial carcinoma with high-grade features: a clinicopathological and TCGA-based molecular analysis.Virchows Archiv : an international journal of pathology · 2023Article
- Claudin‑9 is a novel prognostic biomarker for endometrial cancer.International journal of oncology · 2022Article
- TCGA Molecular Prognostic Groups of Endometrial Carcinoma: Current Knowledge and Future Perspectives.International journal of molecular sciences · 2022Review
- A new strategy in molecular typing: the accuracy of an NGS panel for the molecular classification of endometrial cancers.Annals of translational medicine · 2022Article
- Prospective molecular classification of endometrial carcinomas: institutional implementation, practice, and clinical experience.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2022Article
- The evolving role of morphology in endometrial cancer diagnostics: From histopathology and molecular testing towards integrative data analysis by deep learning.Frontiers in oncology · 2022Review
- Current Prognostic and Predictive Biomarkers for Endometrial Cancer in Clinical Practice: Recommendations/Proposal from the Italian Study Group.Frontiers in oncology · 2022Review
- New Pathological and Clinical Insights in Endometrial Cancer in View of the Updated ESGO/ESTRO/ESP Guidelines.Cancers · 2021Review
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Authors and funding
9 authors at 4 institutions in 3 countries.
Funding
Abstract
Endometrial carcinoma (EC), as described by Bokhman, has historically been classified as Type I (low-grade, hormone-dependant, young patients, good prognosis) or Type II (high-grade, hormone-independent, older patients, poor prognosis). This classification is no longer pragmatic, however, as EC is a much more heterogeneous disease. Four molecular subtypes of EC were identified by The Cancer Genome Atlas (TCGA), and subsequent studies have demonstrated its utility in predicting prognosis. While endometrial serous carcinoma (ESC), the prototypical Type II EC, largely occurs in older women, younger women with ESC were not accounted for in the Bokhman model and were underrepresented in the TCGA study. We hypothesized that a subset of ESCs in young patients do not represent bona fide serous carcinomas but rather high-grade endometrioid carcinomas mimicking a serous phenotype. We identified ESCs and mixed endometrioid/serous carcinomas in women <60 years (n=37), and analyzed their clinical, morphologic, immunohistochemical, and molecular characteristics. Sixteen percent showed mismatch repair deficiency (MMR-D) and 11% were diagnosed with Lynch syndrome. Additionally, 16% of cases tested harbored a hotspot POLE exonuclease domain mutation (POLE-EDM). Morphologically, 47% of tumors showed confirmatory endometrioid features, including atypical hyperplasia, a low-grade endometrioid carcinoma component, or squamous differentiation. Clinically, the overall survival in patients with MMR-D and POLE-EDM was significantly better than that of patients without these features (P=0.0329). In conclusion, ESCs in young patients comprise a heterogeneous group of tumors, demonstrating diverse clinical, immunohistochemical, morphologic, and molecular features which have implications for prognosis and adjuvant therapy.
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