الفهرس 
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Abstract
Summary & Conclusion : Endometrial carcinoma is the commonest gynecological cancer worldwide. It has been traditionally classified into two types: type I estrogen dependent low-grade tumors with favorable prognosis and type II of non-endometrioid histology mainly serous type with poor outcome. Hereditary breast ovarian cancer syndrome (HBOC) is characterized by germline mutation of BRCA1 gene. Whether uterine serous carcinoma could be a part of HBOC is controversial since the link between BRCA1 mutation and serous carcinoma is not well established yet. Such relation has many clinical and genetic implication regarding the prognosis, platinum-based therapy protocols and enrollment in genetic testing and BRCA1 gene mutation surveillance. Although genetic testing is an efficient method for assessing BRCA1 mutation, it is expensive and unavailable in most of cancer institutes. Immunohistochemical staining could be alternative, inexpensive, and widely available method to detect or estimate the BRCA1 mutation in tissue sections, where negative expression is considered to indicate mutational protein loss. In this study we aimed to assess the BRCA1 expression in cases of endometrial carcinoma, then correlate this expression to histopathological parameters as well as evaluating its prognostic relevance on such cases. This was a retrospective study conducted on 94 formalin fixed paraffin embedded specimens for cases of endometrial carcinoma. The specimens were retrieved from the archives of surgical pathology laboratories in Mansoura University Hospital and Mansoura Oncology Center, Mansoura University. Hematoxylin and Eosin (H&E) stained slides were reviewed to assess histopathological parameters. Immunohistochemical staining for BRCA1 was performed and the results were statistically analyzed. Then we evaluated their relationship with different histopathological parameters in endometrial carcinoma and with the disease-free survival DFS and overall survival OS. BRCA1 IHC expression appeared to have a great diagnostic relevance in differentiation between endometroid and serous cases raising the possibility of incorporation of uterine serous carcinoma to HBOC. BRCA1 expression loss was strongly correlated with the serous subtype and were more evident in high grade endometrioid cases compared to lower grades. Although negative cases tend to have shorter duration of DFS, BRCA1 expression didn’t appear statistically to affect the prognosis. Other factors such as grade, stage, microscopic type, and omental deposit had significant relation with DFS however, when multivariate analysis was done, none of which appeared to be an independent prognostic parameter. Therefore, we recommend further studies with longer period of follow up and larger sample size to reinvestigate the prognostic significance of BRCA1 expression on endometrial carcinoma cases. In conclusion, we suggest that BRCA1 is a good diagnostic marker for uterine serous carcinoma. Additionally, serous carcinoma could be a BRCA1 related special entity that may be a part of HBOC syndrome indicating that such cases can be responsive to PARP inhibitors.