Nrf2 expression in endometrial serous carcinomas and its precancers

Ning Chen, Xiaofang Yi, Nisreen Abushahin, Shujie Pang, Donna Zhang, Beihua Kong, Wenxin Zheng

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Endometrial serous carcinoma (ESC) is the most aggressive subtype of endometrial cancer. Its aggressive behavior and poor clinical outcome may be partially attributed to lack of early diagnostic markers and unclear pathogenesis. The transcription factor Erythroid-E2-related factor 2 (Nrf2) is a recently identified protein marker, which plays a role in carcinogenesis as well as responsible for poor prognosis of many human cancers. The aim of this study is to determine the Nrf2 expression in benign endometrium (n=28), endometrial cancers (n=122) as well as their precursor lesions (n=81) trying to see whether Nrf2 has any diagnostic usage and is potentially involved in endometrial carcinogenesis. The level of Nrf2 was evaluated by immunohistochemical (IHC) and verified by using Western blots. Among the malignant cases, Nrf2 was positive in 28 (68%) of 50 ESCs, which was significantly more than in 3 (6%) of 50 endometrioid carcinomas (p < 0.001) and 2 (13%) of 15 clear cell carcinomas (p = 0.001) and other histologic types of endometrial cancers. Among endometrial precursor lesions, both serous endometrial glandular dysplasia (EmGD, 40%) and serous endometrial intraepithelial carcinoma (EIC, 44%) showed a significantly higher Nrf2 expression than that in atypical endometrial hyperplasia or endometrial intraepithelial neoplasia (0%), clear cell EmGD (10%), and clear cell EIC (25%), respectively. We conclude that Nrf2 overexpression is closely associated with endometrial neoplasms with serous differentiation. Alteration of Nrf2 expression may represent one of the early molecular events in ESC carcinogenesis and overexpression of Nrf2 may used as a diagnostic marker in surgical pathology.

Original languageEnglish (US)
Pages (from-to)85-96
Number of pages12
JournalInternational Journal of Clinical and Experimental Pathology
Volume4
Issue number1
StatePublished - Nov 2 2011

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Keywords

  • Endometrial cancer
  • Endometrial glandular dysplasia
  • Endometrial serous carcinoma
  • Nrf2
  • Precancer

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

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