Marwa M. Abd ElAziz

Cyclin D1 expression predicts mismatch repair deficiency and correlates significantly with overall survival and recurrence free survival in endometrial carcinoma

Endometrial carcinoma is among the most common female malignancies. Many prognostic factors of endometrial carcinoma are proposed to predict survival in endometrial carcinoma patients. Cyclin D1 has been implicated in many malignancies including gastrointestinal and breast carcinoma. To correlate the immunohistochemical expression of Cyclin D1 in endometrial carcinoma with the different clinicopathological parameters. Forty-five cases of endometrial carcinoma with different histological subtypes and grades were included. Cyclin D1 expression was immunohistochemically tested. For each case, the predominant intensity was recorded, the density (as the percentage of positively stained cells irrespective of intensity) and H-score were recorded. Moreover, immunohistochemical staining for p53 and mismatch repair (MMR) proteins was done. All included cases showed different degrees of Cyclin D1 expression. Cyclin D1 expression was predominantly strong in 20 cases (44.4%). The density ranged from 1 to 90% and the H-score ranged from 1 to 270. Both H-score and density correlated significantly with MMR deficiency (p = 0.024 & p = 0.043 respectively) with different cut-offs (> 65 and >  20 respectively). Similarly, a predominant strong intensity correlated significantly with MMR deficiency (p = 0.023). Only Cyclin D1 density correlated significantly with FIGO grade (p = 0.036). At the assigned cut-off, H-score correlated significantly with the overall survival (p = 0.023). When predominantly moderately expressed, Cyclin D1 correlated significantly with recurrence free survival (p = 0.038). Cyclin D1 expression may predict MMR status and correlates with both overall survival and recurrence free survival in endometrial carcinoma.