The Diagnostic and Prognostic Significance of ARID1A and CD8+ Expression in Endometrial Hyperplasia and Endometrial Endometrioid Adenocarcinoma (Immunohistochemical study)

Abstract

Background: Epigenetic driver mutations and tumor microenvironment could play an important and promising role in diagnosis, prognosis, and prediction of different endometrial lesions. Aim: To determine their putative diagnostic and prognostic value, this work analyzes the immunohistochemical (IHC) expression of ARID1A and CD8+ in endometrial hyperplasia (EH) and endometrioid endometrial adenocarcinoma (EEA). Material and methods: The 80 distinct endometrial lesions included in this retrospective study included (20) EH without atypia, (30) atypical EH (AEH), and (30) EEA. Clinicopathological characteristics and survival of examined cases were correlated with the IHC expression of ARID1A and CD8+. Results: ARID1A negative expression was significantly associated with EEA (46.7%) and AEH (30%), while its positivity was associated with EH without atypia cases (100%) (P<0.01). ARID1A showed 100% specificity and 38.3% sensitivity for premalignant (AEH) and malignant lesions. When compared to normal endometrium and EH without atypia, the amount of intraepithelial and stromal CD8+ expression revealed a significant difference between the examined cases (P<0.01 and P<0.05, respectively). ARID1A loss and high CD8+ expression was shown to be significantly correlated (P<0.01). Longer disease-free and recurrence-free survival were linked to ARID1A loss and high CD8+ expression. There was no discernible relationship between tumor grade, histologic type, lympho-vascular invasion, lymph node metastasis, or FIGO stage and either ARID1A or CD8+. Conclusion: ARID1A can be a reliable diagnostic indicator for premalignant lesions. ARID1A and CD8+ can each independently indicate a patient's increased chance of living longer and serve as biomarkers for the effectiveness of immunotherapy.