ArticleThe journal of pathology. Clinical research2022
Selection of endometrial carcinomas for p53 immunohistochemistry based on nuclear features.
Article in The journal of pathology. Clinical research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Artificial Intelligence and Digital Pathology for Molecular Classification of Endometrial Cancer.International journal of molecular sciences · 2026Review
- ARID1A, β-Catenin and P53 Immunohistochemical Expression: Diagnostic Value in Endometrial Carcinoma and Premalignant Endometrial Lesions.Iranian journal of pathology · 2026Article
- Correlating p53 immunostaining patterns with somatic TP53 mutation and functional properties of mutant p53 in triple-negative breast cancer.Histopathology · 2025Article
- Abnormal p53 High-Grade Endometrioid Endometrial Cancer: A Systematic Review and Meta-Analysis.Cancers · 2024Review
- The association between body mass index and molecular subtypes in endometrial carcinoma.Gynecologic oncology reports · 2024Article
- Mesonephric-type adenocarcinomas of the ovary: prevalence, diagnostic reproducibility, outcome, and value of PAX2.The journal of pathology. Clinical research · 2024Article
- AI-based histopathology image analysis reveals a distinct subset of endometrial cancers.Nature communications · 2024Article
- Clinical Behavior and Molecular Landscape of Stage I p53-Abnormal Low-Grade Endometrioid Endometrial Carcinomas.Clinical cancer research : an official journal of the American Association for Cancer Research · 2023Article
- p53 and ovarian carcinoma survival: an Ovarian Tumor Tissue Analysis consortium study.The journal of pathology. Clinical research · 2023Article
- Variability in endometrial carcinoma pathology practice: opportunities for improvement with molecular classification.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2022Article
- The Evolution of Ovarian Carcinoma Subclassification.Cancers · 2022Review
- Improving the Diagnosis of Endometrial Hyperplasia Using Computerized Analysis and Immunohistochemical Biomarkers.Frontiers in reproductive health · 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
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10 authors.
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Abstract
The World Health Organization endorses molecular subclassification of endometrial endometrioid carcinomas (EECs). Our objectives were to test the sensitivity of tumor morphology in capturing p53 abnormal (p53abn) cases and to model the impact of p53abn on changes to ESGO/ESTRO/ESP (European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology) risk stratification. A total of 292 consecutive endometrial carcinoma resections received at Foothills Medical Centre, Calgary, Canada (2019-2021) were retrieved and assigned to ESGO risk groups with and without p53 status. Three pathologists reviewed the representative H&E-stained slides, predicted the p53 status, and indicated whether p53 immunohistochemistry (IHC) would be ordered. Population-based survival for endometrial carcinomas diagnosed during 2008-2016 in Alberta was obtained from the Alberta Cancer Registry. The cohort consisted mostly of grade 1/2 endometrioid carcinomas (EEC1/2; N = 218, 74.6%). One hundred and fifty-two EEC1/2 (52.1% overall) were stage IA and 147 (50.3%) were low risk by ESGO. The overall prevalence of p53abn and subclonal p53 was 14.5 and 8.3%, respectively. The average sensitivity of predicting p53abn among observers was 83.6%. Observers requested p53 IHC for 39.4% with 98.5% sensitivity to detect p53abn (99.6% negative predictive value). Nuclear features including smudged chromatin, pleomorphism, atypical mitoses, and tumor giant cells accurately predicted p53abn. In 7/292 (2.4%), p53abn upgraded ESGO risk groups (2 to intermediate risk, 5 to high risk). EEC1/2/stage IA patients had an excellent disease-specific 5-year survival of 98.5%. Pathologists can select cases for p53 testing with high sensitivity and low risk of false negativity. Molecular characterization of endometrial carcinomas has great potential to refine ESGO risk classification for a small subset but offers little value for approximately half of endometrial carcinomas, namely, EEC1/2/stage IA cases.
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