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Dondi G, Coluccelli S, De Leo A, Ferrari S, Gruppioni E, Bovicelli A, Godino L, Coadă CA, Morganti AG, Giordano A, Santini D, Ceccarelli C, Turchetti D, De Iaco P, Perrone AM. An Analysis of Clinical, Surgical, Pathological and Molecular Characteristics of Endometrial Cancer According to Mismatch Repair Status. A Multidisciplinary Approach. Int J Mol Sci 2020; 21:E7188. [PMID: 33003368 PMCID: PMC7582893 DOI: 10.3390/ijms21197188] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 09/25/2020] [Accepted: 09/26/2020] [Indexed: 12/17/2022] Open
Abstract
Since 2016, our hospital has applied tumor testing with immunohistochemistry (IHC) in endometrial cancer in order to detect mutations of mismatch repair genes (MMR). All cases with MMR deficiency proteins expression are sent for genetic testing, except those with MLH1 protein deficiency, in which case genetic testing is performed if negative for promoter hypermethylation. The primary aim of this study was to investigate the ability of our algorithm to identify Lynch syndrome (LS). The Secondary aims were to investigate the relationship between MMR status and clinicopathological features and prognosis of primary endometrial cancer (EC). From January 2016 to December 2018, 239 patients with EC were retrospectively analyzed and subdivided according to MMR status. Patients were divided in three groups: MMR proficient, LS and Lynch-like cancer (LLC). LS was characterized by a lower age and BMI, more use of contraceptive and less use of hormonal replacement therapy, nulliparity and a trend versus a better prognosis. LLC appeared more related to MMR proficient than LS and exhibited a more aggressive behavior. Our multidisciplinary approach permitted a correct diagnosis of germline mutation in patients with newly diagnosis EC and it confirmed clinicopathologic and prognostic characteristics of LS.
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Affiliation(s)
- Giulia Dondi
- Gynecologic Oncology Unit, Azienda Ospedaliero-Universitaria Policlinico di Sant’Orsola, 40138 Bologna, Italy; (G.D.); (S.C.); (A.B.); (P.D.I.)
- Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, 40138 Bologna, Italy; (A.D.L.); (A.G.M.); (D.S.); (C.C.); (D.T.)
| | - Sara Coluccelli
- Gynecologic Oncology Unit, Azienda Ospedaliero-Universitaria Policlinico di Sant’Orsola, 40138 Bologna, Italy; (G.D.); (S.C.); (A.B.); (P.D.I.)
- Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, 40138 Bologna, Italy; (A.D.L.); (A.G.M.); (D.S.); (C.C.); (D.T.)
- Center for Applied Biomedical Research, Alma Mater Studiorum-University of Bologna, 40138 Bologna, Italy;
| | - Antonio De Leo
- Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, 40138 Bologna, Italy; (A.D.L.); (A.G.M.); (D.S.); (C.C.); (D.T.)
- Molecular Diagnostic Unit, Azienda USL Bologna, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Simona Ferrari
- Unit of Medical Genetics, Azienda Ospedaliero-Universitaria Policlinico di Sant’Orsola, University of Bologna, 40138 Bologna, Italy; (S.F.); (L.G.)
| | - Elisa Gruppioni
- Laboratory of Oncologic and Transplantation Molecular Pathology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy;
| | - Alessandro Bovicelli
- Gynecologic Oncology Unit, Azienda Ospedaliero-Universitaria Policlinico di Sant’Orsola, 40138 Bologna, Italy; (G.D.); (S.C.); (A.B.); (P.D.I.)
| | - Lea Godino
- Unit of Medical Genetics, Azienda Ospedaliero-Universitaria Policlinico di Sant’Orsola, University of Bologna, 40138 Bologna, Italy; (S.F.); (L.G.)
| | - Camelia Alexandra Coadă
- Center for Applied Biomedical Research, Alma Mater Studiorum-University of Bologna, 40138 Bologna, Italy;
| | - Alessio Giuseppe Morganti
- Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, 40138 Bologna, Italy; (A.D.L.); (A.G.M.); (D.S.); (C.C.); (D.T.)
- Radiation Oncology Center, Azienda Ospedaliero-Universitaria Policlinico di Sant’Orsola, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Antonio Giordano
- Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA;
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Donatella Santini
- Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, 40138 Bologna, Italy; (A.D.L.); (A.G.M.); (D.S.); (C.C.); (D.T.)
- Pathology Unit Azienda Ospedaliero-Universitaria Policlinico di Sant’Orsola, 40138 Bologna, Italy
| | - Claudio Ceccarelli
- Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, 40138 Bologna, Italy; (A.D.L.); (A.G.M.); (D.S.); (C.C.); (D.T.)
- Molecular Diagnostic Unit, Azienda USL Bologna, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Daniela Turchetti
- Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, 40138 Bologna, Italy; (A.D.L.); (A.G.M.); (D.S.); (C.C.); (D.T.)
- Unit of Medical Genetics, Azienda Ospedaliero-Universitaria Policlinico di Sant’Orsola, University of Bologna, 40138 Bologna, Italy; (S.F.); (L.G.)
| | - Pierandrea De Iaco
- Gynecologic Oncology Unit, Azienda Ospedaliero-Universitaria Policlinico di Sant’Orsola, 40138 Bologna, Italy; (G.D.); (S.C.); (A.B.); (P.D.I.)
- Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, 40138 Bologna, Italy; (A.D.L.); (A.G.M.); (D.S.); (C.C.); (D.T.)
| | - Anna Myriam Perrone
- Gynecologic Oncology Unit, Azienda Ospedaliero-Universitaria Policlinico di Sant’Orsola, 40138 Bologna, Italy; (G.D.); (S.C.); (A.B.); (P.D.I.)
- Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, 40138 Bologna, Italy; (A.D.L.); (A.G.M.); (D.S.); (C.C.); (D.T.)
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