Keap1, Estrogen and Progesterone Receptors as Prognostic Factors in Endometrial Carcinoma: An Immunohistochemical study

Abstract

Author(s): Aya S Amer, Heba A Mashhour, Hanan A AlShenawy, Hassan Tahseen Sheir and Alaa I Amer*

Background: Endometrial carcinoma is the most common malignancy of the female reproductive system and represents the sixth most prevalent malignant tumour all over the world. The purpose of this study was to evaluate the expression of Keap1, estrogen and progesterone receptors immunoreactivities in a spectrum of endometrial carcinoma cases and correlate Keap1, estrogen and progesterone receptors immunohistochemistry expression in the endometrial carcinoma with available clinicopathological parameters. Paraffin blocks from 70 cases of endometrial carcinoma, 52 cases of endometrioid type and 18 cases of non-endometrioid type were subjected to H&E staining and immunohistochemical staining by Keap1, estrogen and progesterone receptors. Results: Keap1 was expressed as cytoplasmic staining mainly and its expression was related to worse prognosis as it was statistically significant associated with non-endometrioid type, high grade, higher stage, deep myometrial invasion and lymphovascular invasion. Estrogen and progesterone receptors were expressed as nuclear staining. Estrogen and progesterone receptors expression was with good prognosis. Both ER and PR expressions associated significantly with endometrioid type and low grade .ER positive tumours were also associated significantly with; early stage, less myometrial invasion and no lymphovascular invasion while PR receptor status did not exhibit significant relation between its expression, FIGO staging, depth of myometrial invasion and lymphovascular invasion. Conclusions: Keap1 could be a useful prognostic factor in endometrial carcinoma. Keap1 expression is related to non-endometrioid type, high grade, higher stage, deep myometrial invasion and lymphovascular invasion and subsequently is associated with worse prognosis. Both ER and PR expressions were related significantly with endometrioid type and low grade, thus related to good prognosis.

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