Prognostic Significance of ER, PR, Ki67, c-erbB-2, and p53 in Endometrial Carcinoma
Cheepsumon Suthipintawong MD*, Charnyut Wejaranayang MD**, Chroen Vipupinyo MD**
Affiliation : * Department of Pathology, Rajavithi Hospital, Bangkok ** Gynecologic Oncology Division, Department of Obstetrics & Gynecology, Rajavithi Hospital, Bangkok
Objective : To better discern the prognostic significance of estrogen-progesterone (ER-PR) receptor, prolifera-
tive index, tumor suppressor gene, and over expression of oncogene c-erbB-2 in correlation with survival time
and recurrence of tumor.
Material and Method: Paraffin blocks from 65 cases of endometrial carcinoma diagnosed and treatment at
Rajavithi Hospital, Bangkok, Thailand with a follow-up time of at least 60 months were immunohistochemical
studied for ER and PR status, tumor proliferative index (Ki-67), tumor suppressor gene (p53), and overexpression
of oncogene c-erbB-2. Survival analysis was performed with the Cox proportional hazards.
Results : The mean age of the patients was 54.94 years with a range of 24 to 80 years. The mean follow-up time
was 50.35 months. Nine patients (13.8%) had recurrent tumors, 5 years after treatment. Ten patients (15.4%)
died of the primary disease during the follow-up period. ER was positive in 50 cases (76.9%) and negative in
15 cases (23.1%). PR was positive in 47 cases (72.3%) and negative in 18 cases (27.7%). Both ER and PR
showed significant correlation (p < 0.01). Ki-67 showed 27 cases (41.5%) having > 35% positive nuclear
staining and 38 cases (58.5%) had < 35% positive nuclear staining. p53 was positive in 31 cases (47.7%) and
negative in 34 cases (52.3%). c-erbB-2 was positive in one case (1.5%), equivocal in six cases (9.2%), and
negative in 58 cases (89.3%).
Conclusion : Survival analysis showed that cases with low-stage, low-grade, no recurrent tumor, ER and PR
positive, and Ki-67 < 35% had good survival compared to cases with high-stage, high-grade, presence of
recurrent tumor, ER-PR-negative, and Ki-67 > 35% (p < 0.05). Cox regression analysis showed ER-PR status
and Ki-67 were significant independent prognostic indicators for survival time. Ki-67 expression was also a
significant independent prognostic indicator for recurrent tumor. p53 and c-erbB-2 displayed no statistical
significance related to survival time.
Keywords : Endometrial carcinoma, ER, PR, Ki-67, p53, c-erbB-2
