Fascin expression in low-grade uterine endometrioid adenocarcinoma: correlation with microcystic, elongated and fragmented (MELF)-type alteration at the deep invasive margin

Stewart, Colin J.R.; Crook, Maxine L.; Manso, L.A. San José

doi:10.1111/j.1365-2559.2011.03893.x

Cited by 25 publications

(25 citation statements)

References 40 publications

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“…The fascin staining pattern observed in the differentiated component of most dedifferentiated tumors was similar to our previous findings in low-grade endometrioid carcinomas, where 18 of 28 cases showed staining in less than 10% of the glandular tumor cells [18]. Similarly, Gun et al [19] found that most grade 1 and grade 2 endometrial carcinomas were fascin negative, or showed limited extent and intensity of staining.…”

Section: Discussionsupporting

confidence: 64%

“…Each case was immunostained for fascin as previously described [18]. For the dedifferentiated carcinomas, one or more blocks were examined if necessary to include both the differentiated and undifferentiated tumor components.…”

Section: Immunohistochemistrymentioning

confidence: 99%

“…In some types of tumor, EMT is associated with increased or novel expression of the actin-binding protein fascin-1 (hereafter fascin), which enhances cellular motility and migration [15][16][17]. In low-grade endometrial endometrioid carcinoma, fascin expression is particularly associated with tumor areas exhibiting microcystic, elongated, and fragmented appearances, and this may represent an EMT-like process [18][19][20]. However, few studies have examined fascin expression in high-grade endometrial carcinomas, and to our knowledge, none has specifically investigated UEC.…”

Section: Introductionmentioning

confidence: 98%

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Fascin expression in undifferentiated and dedifferentiated endometrial carcinoma

Stewart

Crook

2015

Human Pathology

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Section: Discussionsupporting

confidence: 64%

Section: Immunohistochemistrymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

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Fascin expression in undifferentiated and dedifferentiated endometrial carcinoma

Stewart

Crook

2015

Human Pathology

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“…The neoplastic epithelium in MELF-type invasion usually showed strong fascin immunoreactivity. The localized increase in fascin expression suggests that the MELF changes represent areas of active tumor invasion (Stewart et al 2011). Pavlakis et al (2011) demonstrated significant association between MELF pattern of myometrial invasion and lymph node metastasis which could be considered as an additional factor for advanced stage disease.…”

Section: Melf Type Invasionmentioning

confidence: 99%

Tumor progression, metastasis, and modulators of epithelial–mesenchymal transition in endometrioid endometrial carcinoma: an update

Makker

Goel

2015

Endocrine-Related Cancer

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Endometrioid endometrial carcinoma (EEC), also known as type 1 endometrial cancer (EC), accounts for over 70-80% of all cases that are usually associated with estrogen stimulation and often develops in a background of atypical endometrial hyperplasia. The increased incidence of EC is mainly confined to this type of cancer. Most EEC patients present at an early stage and generally have a favorable prognosis; however, up to 30% of EEC present as high risk tumors, which have invaded deep into the myometrium at diagnosis and progressively lead to local or extra pelvic metastasis. The poor survival of advanced EC is related to the lack of effective therapies, which can be attributed to poor understanding of the molecular mechanisms underlying the progression of disease toward invasion and metastasis. Multiple lines of evidence illustrate that epithelial-mesenchymal transition (EMT)-like events are central to tumor progression and malignant transformation, endowing the incipient cancer cell with invasive and metastatic properties. The aim of this review is to summarize the current knowledge on molecular events associated with EMT in progression, invasion, and metastasis of EEC. Further, the role of epigenetic modifications and microRNA regulation, tumor microenvironment, and microcystic elongated and fragmented glands like invasion pattern have been discussed. We believe this article may perhaps stimulate further research in this field that may aid in identifying high risk patients within this clinically challenging patient group and also lead to the recognition of novel targets for the prevention of metastasis -the most fatal consequence of endometrial carcinogenesis.

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“…18 Of interest, ECas with a MELF pattern of myometrial invasion may be related to the concept of epithelial mesenchymal transition, as they tend to show greater expression of cytokeratins 7 and 19, cyclin D1, fascin, p16, and loss or reduced expression of ER and PR, galectin-3, CD147, Ki-67, and β-catenin when compared with the usual type of ECa. [21][22][23][24][25][26] ECa with small non-villous papillae. This morphological variant of ECa shows pseudopapillae lacking fibrovascular cores projecting into gland lumens or extending from the surface of the finger-like papillae that characterize villoglandular ECa.…”

Section: Papillary Tumorsmentioning

confidence: 99%

How to approach the many faces of endometrioid carcinoma

Malpica

2016

Modern Pathology

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This article reviews the salient features of variants of endometrioid carcinoma (ECa) that can pose a diagnostic challenge and/or are associated with unique clinicopathological findings. Variants with distinct architectural and cytologic features include the following: (1) ECa with a villoglandular pattern (tumor with finger-like papillae lined by bland cells with a tendency for vascular/lymphatic invasion and lymph node metastasis once this pattern is seen within the myoinvasive component); (2) papillary ECa of intermediate grade (grade 2) (tumor that can be mistaken for serous carcinoma, as it contains papillae showing slightly irregular contours, moderately atypical cells, and it is associated with vascular/lymphatic invasion/lymph node metastasis, but with common association with mucinous metaplasia, MELF (microcystic, elongated, and fragmented) pattern of invasion, and wild p53 expression); (3) ECa with non-villous papillae (tumor containing pseudopapillae within glands with bland-appearing cytology commonly associated with abortive squamous differentiation and otherwise not different from usual ECa); (4) ECa with microglandular-like pattern (tumor that mimics microglandular hyperplasia of the cervix, often lacking the typical appearance of microglandular hyperplasia and showing Ki-67 index 410%, strong CD10 expression, and negative PAX-2, p63, and CD34); and (5) ECa with sex cord-like formations and hyalinization (tumor with interconnected cords and nests of bland epithelioid and spindled cells that merge with a typical component of low-grade ECa, usually associated with squamous differentiation and hyalinization). This tumor should be distinguished from carcinosarcoma and, in contrast to the latter, it shows nuclear β-catenin expression, ER/PR and patchy p16 positivity, tends to present at a low stage, and has a favorable prognosis and (6) dedifferentiated ECa (tumor showing a low-grade ECa juxtaposed to an undifferentiated carcinoma-the latter characterized by variably sized monotonous, often non-cohesive cells with brisk mitotic activity and usually arranged in sheets). Undifferentiated carcinoma tends to be negative for PAX8 and ER/PR with variable expression of keratins and can be associated with microsatellite instability (may be part of Lynch syndrome). Variants with distinct cytological features include the following: (1) ECa with clear cells (tumors with clearing due to 'clear' (glycogenated) squamous cells, distinct vacuoles, or not otherwise specified. EC with clear cells should be distinguished from clear cell carcinoma by the absence of the variety of architectural patterns, lack of cuboidal/flattened/hobnail cells, and lack of degree of atypia usually detected in clear cell carcinoma. In addition, they are ER/PR positive and Napsin A and p504S negative in contrast to clear cell carcinoma); (2) ECa with spindle cells (tumor with transition from spindle cells to the glandular component of a low-grade ECa. The spindle cells are keratin, ER/PR, and patchy p16 positive and show wild-type p53 expre...

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Fascin expression in low-grade uterine endometrioid adenocarcinoma: correlation with microcystic, elongated and fragmented (MELF)-type alteration at the deep invasive margin

Abstract: There are distinct micro-anatomical variations in fascin immunoreactivity within endometrial carcinoma. The localized increase in fascin expression in MELF-type epithelium supports the proposal that MELF changes represent areas of active tumour invasion.

Cited by 25 publications

References 40 publications

Fascin expression in undifferentiated and dedifferentiated endometrial carcinoma

Fascin expression in undifferentiated and dedifferentiated endometrial carcinoma

Tumor progression, metastasis, and modulators of epithelial–mesenchymal transition in endometrioid endometrial carcinoma: an update

How to approach the many faces of endometrioid carcinoma

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