Diagnostic and Prognostic utility of Hormone receptors and KI67 in Proliferative Endometrial lesions

Background: The overall survival rate of patients with early-stage endometrial cancer is relatively high; how-ever, there are few treatment options for patients with advanced or recurrent endometrial cancer, and the prognosis of such patients remains poor. Recent progress in molecular-targeted therapies demonstrated that they have the potential to improve the long-term survival of cancer patients with appropriate biomarkers. In this study we evaluated 50 patients with endometrial proliferative lesions and their correlation with hormonal receptors and proliferative index, with emphasis on the utility of these markers in disease prognosis. Objective: To evaluate the association of expression of ER, PR and Ki67 in endometrial hyperplasia and carcinoma. Material and Methods: Small and large biopsy samples obtained from 50 female patients were evaluated by histopathology and immunohistochemistry by using specific markers. Statistical analysis was done to determine the P value. Results: Out of 50 cases studied 16 cases (32%) were endometrial hyperplasia and 34 cases (68%) were of endometrial carcinoma. Among the carcinoma cases 22 cases (65%) were grade 3, 8 (23%) were grade 2 and 4(12%) were grade 1 tumors. Assessment of myometrial invasion was possible in 23 cases out of which 20 cases showed >50% invasion and 3 cases showed <50% invasion. Cervical invasion was present in 17 cases and vascular invasion was seen in 10 cases. Negative expression of hormonal receptors was seen in grade 3 (high grade) endometrial carcinomas. P value was estimated at 0.0001. The proliferative index was high (>35%) in grade 3 (high grade) endometrial carcinoma. P value was 0.006.Conclusion: There is significant association of expression of ER, PR and Ki67 in endometrial carcinomas with respect to histological variants, grade, tumor invasion and metastasis