Gynecologic Pathology
Fatemeh Nili; Soheib Fathi; Mansoureh Tavakoli; Elham Mirzaian; Maryam Lotfi
Abstract
Background & Objective: Clear cell carcinoma (CCC) is an uncommon histopathologic subtype of ovarian and endometrial carcinoma. Due to the morphologic overlapping with other subtypes of ovarian and endometrial carcinomas, an accurate diagnosis is crucial.Methods: In this study, 31 cases of ovarian ...
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Background & Objective: Clear cell carcinoma (CCC) is an uncommon histopathologic subtype of ovarian and endometrial carcinoma. Due to the morphologic overlapping with other subtypes of ovarian and endometrial carcinomas, an accurate diagnosis is crucial.Methods: In this study, 31 cases of ovarian clear cell carcinoma (OCCC), 28 endometrial clear cell carcinoma (ECCC), and 80 non-CCC subtypes (33 high-grade serous carcinomas of the ovary, 2 low-grade serous carcinomas, 10 ovarian endometrioid, 3 serous carcinomas and 29 endometrioid carcinomas of the endometrium) were investigated for immunohistochemical expression of AMACR. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the distinction of OCCC and ECCC from other histopathologic subtypes were calculated.Results: Positive AMACR staining was seen in 18 OCCCs (58%) and 10 ECCCs (35.7%). In the non-clear cell group, 44 cases of ovarian (98%) and 25 cases of endometrial carcinoma (78%) showed negative results. Only one case of ovarian endometrioid carcinoma and 7 cases (22%) of endometrial endometrioid carcinomas revealed a positive reaction (P<0.05). Collectively, sensitivity, specificity, PPV, and NPV of AMACR expression, for the diagnosis of OCCC were calculated as 58%, 98%, 94.7%, and 77.2%, respectively. The sensitivity, specificity, PPV, and NPV were shown to be as 35.7%, 78.1%, 58.8%, and 58.1%, respectively in the endometrium.Conclusion: AMACR may be a highly specific immunohistochemical marker for the distinction of serous and clear cell carcinoma. A small percentage of endometrioid carcinoma may show positive staining. The sensitivity of this marker may not be higher than the other well-known Napsin-A IHC marker.
Ali Zare Mirzaei; Fatemeh Abdorrazaghi; Maryam Lotfi; Behrang Kazemi Nejad; Nasrin Shayanfar
Abstract
Background & Objectives: Colon cancer is currently of high incidence and mortality rate. Identifying the factors influencing its prognosis can be very beneficial to its clinical treatment. Recent studies have shown that lymph nodes ratio can be considered as an important prognostic factor. The aim ...
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Background & Objectives: Colon cancer is currently of high incidence and mortality rate. Identifying the factors influencing its prognosis can be very beneficial to its clinical treatment. Recent studies have shown that lymph nodes ratio can be considered as an important prognostic factor. The aim of the present study is to investigate the effect of this factor on the prognosis of the patients presenting with stage III colon cancer and to compare the result with the effect of lymph node stage on their prognosis. Methods: This cross-sectional study was carried out on 66 patients of stage III colon cancer, who met the study inclusion criteria. Patients were categorized into four groups based on Kaplan-Meier plots: LNR1 0-12%, LNR2 13-40%, LNR3 41-84% and LNR4 85-100%. Survival was estimated by Kaplan-Meier method, and differences analyzed by Log-rank test. A Cox proportional hazards model was used for multivariate analysis. Results: Lymph nodes ratio was a significantly variable both in overall survival (P<0.0001) and in disease-free survival (P=0.009). Lymph node stage was significant in overall survival (P=0.008) but not in disease-free survival (P=0.05). Multivariable analysis of overall survival showed lymph nodes ratio as the only independent prognostic factor. Conclusion: Lymph node ratio is a more accurate prognostic factor than lymph node stage in overall survival and, in particular, in disease-free survival in patients with stage III colon cancer.