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Variability in endometrial carcinoma pathology practice: opportunities for improvement with molecular classification.
Thompson, Emily F; Huvila, Jutta; Jamieson, Amy; Leung, Samuel; Lum, Amy; Offman, Saul; Lytwyn, Alice; Sur, Mona Lisa; Hoang, Lynn; Irving, Julie; van der Westhuizen, Nicholas; Morin, Chantale; Bicamumpaka, Cyrille; Azordegan, Nazilla; Gougeon, François; Ennour-Idrissi, Kaoutar; Senz, Janine; McConechy, Melissa K; Aguirre-Hernandez, Rosalia; Lui, Victoria; Kuo, Carolyn; Bell, Cassidy; Salisbury, Taylor; Lawson, James; He, Ellen; Wang, Shanzhao; Chiu, Derek; Kean, Sarah; Samouëlian, Vanessa; Salvador, Shannon; Gotlieb, Walter; Helpman, Limor; Scott, Stephanie; Wohlmuth, Christoph; Vicus, Danielle; Plante, Marie; Talhouk, Aline; Huntsman, David; Parra-Herran, Carlos; Kinloch, Mary; Grondin, Katherine; Gilks, C Blake; McAlpine, Jessica N.
Afiliação
  • Thompson EF; Department of Molecular Oncology, University of British Columbia, Vancouver, BC, Canada.
  • Huvila J; Department of Molecular Oncology, University of British Columbia, Vancouver, BC, Canada.
  • Jamieson A; Department of Pathology, University of Turku, Turku University Hospital, Turku, Finland.
  • Leung S; Department of Gynaecology and Obstetrics and Division of Gynaecologic Oncology, University of British Columbia, Vancouver, BC, Canada.
  • Lum A; Genetic Pathology Evaluation Centre, University of British Columbia, Vancouver, BC, Canada.
  • Offman S; Department of Molecular Oncology, University of British Columbia, Vancouver, BC, Canada.
  • Lytwyn A; Department of Pathology and Laboratory Medicine, Dalhousie University, Halifax, NS, Canada.
  • Sur ML; Department of Pathology and Molecular Medicine, McMaster University and The Juravinski Hospital and Cancer Centre, Hamilton, ON, Canada.
  • Hoang L; Department of Pathology and Molecular Medicine, McMaster University and The Juravinski Hospital and Cancer Centre, Hamilton, ON, Canada.
  • Irving J; Department of Pathology and Laboratory Medicine, University of British Columbia and Vancouver General Hospital, Vancouver, BC, Canada.
  • van der Westhuizen N; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.
  • Morin C; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.
  • Bicamumpaka C; Pathology Department, Centre Hospitalier Universitaire de Québec at Laval University and L'Hôtel-Dieu de Québec, Quebec, QC, Canada.
  • Azordegan N; Department of Pathology, University of Manitoba, Winnipeg, MB, Canada.
  • Gougeon F; Department of Pathology, University of Manitoba, Winnipeg, MB, Canada.
  • Ennour-Idrissi K; Department of Molecular Biology, Medical Biochemistry and Pathology, Centre Hospitalier Universitaire de Montréal at Université de Montréal, Montreal, QC, Canada.
  • Senz J; Department of Molecular Biology, Medical Biochemistry and Pathology, Centre Hospitalier Universitaire de Québec at Université de Laval, Quebec, QC, Canada.
  • McConechy MK; Department of Molecular Oncology, University of British Columbia, Vancouver, BC, Canada.
  • Aguirre-Hernandez R; Canexia Health, Vancouver, BC, Canada.
  • Lui V; Canexia Health, Vancouver, BC, Canada.
  • Kuo C; Faculty of Science, University of British Columbia, Vancouver, BC, Canada.
  • Bell C; Obstetrics, Gynecology and Reproductive Sciences Residency Program, University of Manitoba, Winnipeg, MB, Canada.
  • Salisbury T; MD Undergraduate Program, University of Saskatchewan, Saskatoon, SK, Canada.
  • Lawson J; Department of Pathology and Laboratory Medicine, University of British Columbia and Vancouver General Hospital, Vancouver, BC, Canada.
  • He E; MD undergraduate program, University of British Columbia, Vancouver, BC, Canada.
  • Wang S; MD undergraduate program, University of British Columbia, Vancouver, BC, Canada.
  • Chiu D; Department of Molecular Oncology, University of British Columbia, Vancouver, BC, Canada.
  • Kean S; Department of Molecular Oncology, University of British Columbia, Vancouver, BC, Canada.
  • Samouëlian V; Division of Gynecologic Oncology, University of Manitoba, Winnipeg, MB, Canada.
  • Salvador S; Department of Obstetrics and Gynecology, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.
  • Gotlieb W; Division of Gynecologic Oncology, Lady Davis Institute of Research, Jewish General Hospital, McGill University, Montreal, QC, Canada.
  • Helpman L; Division of Gynecologic Oncology, Lady Davis Institute of Research, Jewish General Hospital, McGill University, Montreal, QC, Canada.
  • Scott S; Division of Gynecologic Oncology, McMaster University and The Juravinski Hospital and Cancer Centre, Hamilton, ON, Canada.
  • Wohlmuth C; Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Dalhousie University, Halifax, NS, Canada.
  • Vicus D; Department of Obstetrics and Gynecology, Paracelsus Medical University, Salzburg, Austria.
  • Plante M; Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University of Toronto, Toronto, ON, Canada.
  • Talhouk A; Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University of Toronto, Toronto, ON, Canada.
  • Huntsman D; Department of Obstetrics, Gynecology and Reproduction, Centre Hospitalier Universitaire de Québec, L'Hôtel-Dieu de Québec, Laval University, Quebec, QC, Canada.
  • Parra-Herran C; Department of Molecular Oncology, University of British Columbia, Vancouver, BC, Canada.
  • Kinloch M; Department of Molecular Oncology, University of British Columbia, Vancouver, BC, Canada.
  • Grondin K; Department of Laboratory Medicine and Pathobiology University of Toronto and Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
  • Gilks CB; Department of Pathology and Laboratory Medicine, University of Saskatchewan and Saskatoon City Hospital, Saskatoon, SK, Canada.
  • McAlpine JN; Pathology Department, Centre Hospitalier Universitaire de Québec at Laval University and L'Hôtel-Dieu de Québec, Quebec, QC, Canada.
Mod Pathol ; 35(12): 1974-1982, 2022 12.
Article em En | MEDLINE | ID: mdl-36241860
ABSTRACT
We assessed the landscape of diagnostic pathology practice and how molecular classification could potentially impact management of patients with endometrial cancer by collecting patient samples, clinicopathologic data, and patient outcomes from EC patients diagnosed in 2016 at 10 Canadian tertiary cancer centers and 19 community hospitals. ProMisE molecular subtype (POLEmut, MMRd, p53abn, No Specific Molecular Profile (NSMP)) was assigned retrospectively. 1357 patients were fully evaluable including 85 POLEmut (6.3%), 380 MMRd (28.0%), 643 NSMP (47.4%), and 249 p53abn ECs (18.3%). Immunohistochemistry (IHC) for MMR proteins was undertaken at the time of primary diagnosis in 2016 in only 42% of the cohort (570/1357; range 3.5-95.4%/center). p53 IHC had only been performed in 21.1% of the cohort (286/1357; range 10.1-41.9%/center). Thus, based on the retrospective molecular subtype assignment, 54.7% (208/380) of MMRd EC had not been tested with MMR IHC (or MSI) and 48.2% (120/249) of p53abn ECs were not tested with p53 IHC in 2016. Molecular subtype diversity within histotypes was profound; most serous carcinomas were p53abn (91.4%), but only 129/249 (51.8%) p53abn EC were serous. Low-grade (Gr1-2) endometrioid carcinomas were mostly NSMP (589/954, 61.7%) but included all molecular subtypes, including p53abn (19/954, 2.0%). Molecular subtype was significantly associated with clinical outcomes (p < 0.001) even in patients with stage I disease (OS p = 0.006, DSS p < 0.001, PFS p < 0.001). Assessment of national pathologic practice in 2016 shows highly variable use of MMR and p53 IHC and demonstrates significant opportunities to improve and standardize biomarker reporting. Inconsistent, non-reflexive IHC resulted in missed opportunities for Hereditary Cancer Program referral and Lynch Syndrome diagnosis, and missed potential therapeutic implications (e.g., chemotherapy in p53abn EC, immune blockade for MMRd EC). Routine integration of molecular subtyping into practice can improve the consistency of EC pathology assessment and classification.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias do Endométrio / Carcinoma Endometrioide Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Female / Humans País/Região como assunto: America do norte Idioma: En Revista: Mod Pathol Assunto da revista: PATOLOGIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Canadá
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias do Endométrio / Carcinoma Endometrioide Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Female / Humans País/Região como assunto: America do norte Idioma: En Revista: Mod Pathol Assunto da revista: PATOLOGIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Canadá