Epithelial-mesenchymal transition in fertility sparing management of endometrial cancer: report of two cases / 부인종양

ABSTRACT

Endometrial cancer (EC) is the most common gynecologic malignancy. A significant number of patients are diagnosed during reproductive age in nowadays. The importance of fertility preservation for EC has become more evident than ever before in this patient population. Hormonal therapy for stage IA low-risk EC is reported efficient and safe. However, the recurrence rate is high and the pregnancy outcomes are not satisfactory. We report 2 patients at reproductive age who were diagnosed of endometrioid EC and underwent fertility preservation treatment. Both of them achieved complete remission but later developed carcinosarcoma. This unusual disease progression may imply the underling mechanism of hormonal resistance. Immunohistochemistry showed that the expression of E-cadherin gradually decreased from epithelium to mesenchymal components, whereas nuclear expression of β-catenin gradually increased. The mesenchymal marker vimentin was abnormally overexpressed in the epithelium. This indicates that epithelial-mesenchymal transition pathway may be involved in the EC cell evolution and hormonal resistance.