Comparative analysis of endometrial carcinoma and carcinosarcoma to identify prognostic factors.

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K16565
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 49020:Human pathology-related
• Research Institution: Jichi Medical University
• Principal Investigator: Kihara Atsushi 自治医科大学, 医学部, 講師 (10806756)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Keywords: 癌肉腫 / 未分化癌 / 脱分化癌 / 子宮体部 / クロマチンリモデリング / ZEB1

Outline of Final Research Achievements

We reviewed archived endometrial carcinosarcomas, some of which were reclassified undifferentiated or dedifferentiated endometrial carcinomas according to the latest WHO classification. To clarify the characteristics of undifferentiated and dedifferentiated endometrial carcinomas, clinicopathological and immunohistochemical studies were performed. Loss of expression of SWI/SNF complex subunits (SMARCA4/SMARCB1/ARID1B) was observed only in undifferentiated and dedifferentiated carcinomas and clear cell carcinomas. SMARCA4/SMARCB1/ARID1B-deficient undifferentiated and dedifferentiated carcinomas had a worse prognosis than carcinosarcoma. Expression of epithelial-mesenchymal transition-related transcription factors was observed in almost all cases of undifferentiated and dedifferentiated carcinomas and carcinosarcomas but was rarely observed in high-grade endometrial carcinomas.

Free Research Field

人体病理学

Academic Significance and Societal Importance of the Research Achievements

子宮体部の未分化癌・脱分化癌は、癌肉腫や高悪性度類内膜癌と形態学的に類似しているため混同しやすく、病理診断において正確な診断が難しい。また、未分化癌・脱分化癌と癌肉腫を異なる疾患単位として捉えるべきか明確でなかった。本研究により、未分化癌・脱分化癌と癌肉腫の間に臨床病理学的な差異があり、少なくとも一部においては発症機序に違いがあることが示唆された。未分化癌・脱分化癌は癌肉腫と異なる独立した疾患で、それらの病理診断に有用な知見を得ることができた。