96. Jahrestagung der Deutschen Gesellschaft für Pathologie e. V ...

Abstracts
SA-P-027
Primary serous peritoneal carcinoma (PPC) with and without
serous tubal in-situ carcinoma (STIC)
L .-C . Horn 1 , K . Leonhardt 2 , K . Kellner 1 , R . Scherling 2 , J . Einenkel 2
1 University of Leipzig, Institute of Pathology, Leipzig, 2 University of Leipzig,
Department of Obstetrics and Gynecology (Institute of Trier), Leipzig
Aims. Evaluating the frequency of serous tubal in situ carcinoma (STIC)
in cases of primary peritoneal carcinoma.
Methods. The present study evaluates immunohistochemically (Ki-67
and p53-staining) the presence of STIC in completely embedded Fallopian
tubes of 35 consecutive cases meeting the clinicopathologic criteria of
primary high-grade serous carcinoma.
Results. p53 signature was seen in four cases (11%) and STIC in seven patients
(20%). All STIC occurred at the fimbriated end of the Fallopian tube
and in one case a bilateral involvement was seen. These precursor lesions
were missed during the initial routine screening. In two cases repeated
staining for p53 was negative.
Conclusions. STIC and p53-signature as precursor lesions of pelvic serous
cancer are seen in some but not all cases of primary serous peritoneal
cancer. Further studies are required to identify the source of serous cancer
in cases without STIC-lesions.
SA-P-028
KPNA2 protein expression is an independent adverse predictor of
survival in patients with endometrial carcinomas
K . Ikenberg1 , A . Noske1 , R . Caduff1 , A . Dellas2 , H . Moch1 , P .J . Wild1 1University Hospital Zurich, Institute of Surgical Pathology, Zürich, Switzerland,
2University of Basel, Institute of Pathology, Basel, Switzerland
Aims. To analyze rates of expression of karyopherin alpha 2 (KPNA2),
an important mediator of nucleocytoplasmic transport, in different endometrial
cancer subtypes, and to evaluate its prognostic properties for
patients with primary endometrial cancer.
Methods. Tissue microarrays (TMA) contained 527 formalin-fixed, paraffin-embedded
endometrial cancer tissue cores from two different
institutes of pathology. TMAs were stained immunohistochemically for
KPNA2 and p53.
Results. KPNA2 expression was significantly upregulated in carcinomas
of the endometrium and was significantly associated with higher tumor
grade, higher FIGO stage, and overexpression of p53. KPNA2 expression
was not associated with different subtypes of endometrial carcinomas.
Positive nuclear KPNA2 immunoreactivity in at least 10% of nuclei was
identified as a novel predictor of survival, and was independent of the
well-established prognostic factors age, grade, FIGO stage, histological
type, and p53 immunoreactivity in Cox regression analyses (hazard ratio=1.7,
95% CI 1.13–2.56, p=0.01).
Conclusions. KPNA2 is a novel independent prognostic marker for survival
after hysterectomy. This may allow identifying patients who need
more aggressive treatment.
SA-P-029
Loss of ARID1A/BAF250a expression in endometriosis – a new
molecular mechanism for transformation into cancer?
A . Noske1 , N . Samartzis2 , M . Rechsteiner1 , H . Moch1 , P . Imesch2 1University Hospital Zurich, Institute of Pathology, Zürich, Switzerland,
2University Hospital Zurich, Dept . of Gynecology, Zürich, Switzerland
Aims. Mutations of the tumor suppressor gene ARID1A are frequently
found in endometriosis-associated ovarian carcinomas, and correlate
with expression loss of the coding protein BAF250a. We hypothesize that
deficient ARID1A/BAF250a expression may contribute in transformation
of endometriosis into cancer.
148 | Der Pathologe · Supplement 1 · 2012
Methods. We evaluated ARID1A/BAF250a protein expression in 74 endometriosis,
and 30 eutopic endometrium samples by immunohistochemistry.
Further, an analysis of ARID1A/BAF250a and p53 expression in
a cohort of 129 primary ovarian carcinomas was performed. To classify
the ovarian carcinomas in type I and type II, the mutational status of p53,
KRAS, and BRAF will be determined by deep-sequencing technology.
Results. There was a loss of ARID1A/BAF250a expression in three endometriomas
and one deep-infiltrating endometriosis, but in none of
the peritoneal endometriosis and eutopic endometrium samples. Lack
of expression was found in 22.5% of the ovarian carcinomas and was
significantly associated with the endometrioid histological subtype and
wild-type p53 protein.
Conclusions. The deficiency of ARID1A/BAF250a expression in few endometriosis
lesions may indicate an early event in malignant transformation
of endometriosis. In context with the literature, the data support
an association of ARID1A and p53 in ovarian cancer.
SA-P-030
Detection of micrometastasis in paraaortic lymph nodes in patients
with carcinoma of the uterine cervix after negative frozen
section analysis
L .-C . Horn1 , K . Kellner1 , R . Scherling2 , M . Höckel2 , J . Einenkel2 1 2 University of Leipzig, Institute of Pathology, Leipzig, University of Leipzig,
Department of Obstetrics and Gynecology (Institute of Trier), Leipzig
Aims. Previous studies considered the presence of micrometastases
(MM) in pelvic lymph nodes as clinically relevant prognostic indicator
and reported a 2.4 to 3.2 greater risk for recurrent disease and dead of
the disease when compared to nodal negative patients. There is limited
information about the value of (immunohistochemical) ultrastaging in
negative para-aortic lymph nodes (PAN).
Methods. Frozen section analysis was performed in all cases with PA-
LNE because of clinical requirements. From all FS-blocks, routinely
three step sections were performed. After FS-examination nodes were
examined by one H&E-stained slide. All nodes without metastatic disease
after frozen section and permanent section examination were subject
of the present study. 43 patients and 418 PAN were enrolled and immunohistochemical
staining using two cytokeratin-cocktail antibodies (AE
1/AE 3 and KL-1) was performed. MM were defined as foci of tumor cells
ranging from 0.2 mm to no more than 2 mm in size; isolated tumor cells
(ITC) are defined as single tumor cells or small clusters of cells less than
0.2 mm in size within the subcapsular sinuses of the lymph node.
Results. In one case, one single node showed micrometastasis, representing
an incidence of 2.3% of the studied cases and 0.23% of the examined
lymph nodes. In three cases benign endosalpingiosis was seen. The
patient with MM is alive without evidence of disease 96 months after
surgery. ITC were not observed.
Conclusions. The frequency of MM in PAN is very low. There are only limited
data regarding their prognostic impact within the literature. After
careful examination of all removed PAN using H&E-staining (and step
sectioning), immunohistochemical ultrastaging cannot be recommend
for routine use.
SA-P-031
Mismatch repair protein expression of cervical adenocarcinoma
B . Helmchen1 , R . Brand2 , M . Kurrer3 , P . Komminoth1 , H .-P . Sinn2 1Community Hospital Triemli, Dept . of Pathology, Zürich, Switzerland,
2University of Heidelberg, Institute for Pathology, Heidelberg,
3Enge Institute of Pathology, Zürich, Switzerland
Aims. Charakterisierung des immunhistochemischen Expressionsprofils
der Mismatch-Repair-Proteine (MMRP) MLH1, MSH2, MSH6 und
PMS2 an primären zervikalen Adenokarzinomen (ZAK) in Abgrenzung
zu Karzinomen des unteren Uterinsegmentes (UUSK).