J Gynecol Oncol.  2017 Jan;28(1):e4. 10.3802/jgo.2017.28.e4.

Genetic screening in young women diagnosed with endometrial cancer

• Pecorino B
• Rubino C
• Guardalà FVF
• Galia A
• Scollo P

• KMID: 2413851
• DOI: http://doi.org/10.3802/jgo.2017.28.e4

Abstract

OBJECTIVE
To evaluate the importance of Lynch syndrome associated risk screening in the patients aged less than 50 years affected from endometrial cancer.
METHODS
From 2007 to 2014, 41 patients affected from endometrial cancer and aged less than 50 years underwent surgery at the Complex Operative Unit of Gynecology and Obstetrics, Cannizzaro Hospital of Catania, Italy. They were selected to undergo mismatch repair gene mutation analysis using immunohistochemistry (IHC; four markers: MLH1, MSH2, MSH6, PMS2) and microsatellite instability (MSI) test. For samples that resulted negative to IHC (abnormal finding), MSI test was performed to further study the suspected mutation. Samples were classified as MSI-high (MSI-H) if more than one marker was identified as unstable; MSI-low (MSI-L) if only one marker was identified as unstable; or MSI-stable (MSI-S) if no marker was identified as unstable. Samples were subdivided into two groups: MSI-H/L and MSI-S. Statistical analysis was performed to assess differences regarding survival, tumor staging, grading, and invasion of lymphovascular space between these two groups.
RESULTS
IHC analysis showed that in 46% (19/41) of samples there was negative outcome. Forty-two percent (8/19) of these negative samples were unstable (either low or high). Of eight patients showing MSI, 75% were MSI-L, while 25% were MSI-H. Differences in survival, stage, grade, lymphovascular space invasion and Amsterdam criteria adherence were not statistically significant due to the small size of the cohort.
CONCLUSION
IHC and MSI test results of our cohort lead us to assess the relevance of performing Lynch syndrome genetic screening in endometrial cancer patients aged less than 50 years at the time of diagnosis.

Keyword

Endometrial Neoplasms; Genetic Testing; Immunohistochemistry; Lynch Syndrome; Young Patients

MeSH Terms

Adenocarcinoma/genetics/pathology/therapy
Adult
Biomarkers, Tumor/genetics
Colorectal Neoplasms, Hereditary Nonpolyposis/*diagnosis
Endometrial Neoplasms/*genetics/pathology/therapy
Female
Genetic Predisposition to Disease
*Genetic Testing
Humans
Middle Aged
MutL Protein Homolog 1
MutS Homolog 2 Protein
Receptors, Immunologic
Retrospective Studies
Biomarkers, Tumor
Receptors, Immunologic
MutL Protein Homolog 1
MutS Homolog 2 Protein