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Clinicopathological Characteristics and KRAS Mutation Status of Endometrial Mucinous Metaplasia and Carcinoma

 Ji-Youn Sung  ;  Yoon Yang Jung  ;  Hyun-Soo Kim 
 ANTICANCER RESEARCH, Vol.38(5) : 2779-2786, 2018 
Journal Title
Issue Date
Mucinous/*genetics/pathology Adenocarcinoma ; Papillary/genetics/pathology Adenocarcinoma ; Adult ; Endometrioid/genetics/pathology Carcinoma ; Endometrial Neoplasms/*genetics/*pathology ; Female ; Humans ; Metaplasia/genetics/pathology ; Middle Aged ; Precancerous Conditions/genetics/pathology ; Proto-Oncogene Proteins p21(ras)/*genetics
Endometrium ; KRAS ; carcinoma ; metaplasia ; mucinous ; papillary
BACKGROUND/AIM: Mucinous metaplasia of the endometrium occurs as a spectrum of epithelial alterations ranging from the formation of simple, tubular glands to architecturally complex glandular proliferation with intraglandular papillary projection and cellular tufts. Endometrial mucinous metaplasia often presents a diagnostic challenge in endometrial curettage. MATERIALS AND METHODS: We analyzed the clinicopathological characteristics and the mutation status for V-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS) of 11 cases of endometrial mucinous metaplasia. Electronic medical record review and histopathological examination were performed. KRAS mutation status was analyzed using a pyrosequencing technique. RESULTS: Cases were classified histopathologically into simple (5/11) or papillary (6/11) mucinous metaplasias. All (6/6) papillary mucinous metaplasias were associated with atypical hyperplasia/endometrioid intraepithelial neoplasia (AH/EIN; 1/6) or carcinoma (5/6), whereas in a single patient with simple mucinous metaplasia, grade 1 endometrioid carcinoma was incidentally detected. The difference in frequency of association of the metaplasia with AH/EIN or carcinoma was significant (p=0.015). KRAS mutations were identified in five out of six cases of papillary mucinous metaplasias, comprising three cases with G12D and two with G12V mutations; the frequency of KRAS mutation was significantly higher (p=0.015) than in cases of simple mucinous metaplasia (0/5). CONCLUSION: Papillary mucinous metaplasia is frequently associated with endometrial neoplastic lesions. The high incidence of KRAS mutations in papillary mucinous metaplasia suggests that papillary mucinous metaplasia may be a precancerous lesion of a certain subset of mucinous carcinomas of the endometrium.
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1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hyun-Soo(김현수)
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