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Open Access Highly Accessed Research

CyclinD1, a prominent prognostic marker for endometrial diseases

Shuo Liang1, Kun Mu12, Yan Wang12, Zhiqiang Zhou12, Juan Zhang2, Yan Sheng1 and Tingguo Zhang12*

Author affiliations

1 Department of Pathology, Shandong University School of Medicine, 44#, Wenhua Xi Road, 250012 Jinan, Shandong, People's Republic of China

2 Department of Pathology, Qilu Hospital of Shandong University, 107#, Wenhua Xi Road, 250012 Jinan, China

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Citation and License

Diagnostic Pathology 2013, 8:138  doi:10.1186/1746-1596-8-138

Published: 15 August 2013

Abstract

Purpose

Alteration of CyclinD1 was suggested to relate with development of endometrial carcinogenesis before, however CyclinD1 expression is not well defined in endometrial hyperplasia lesions. We checked the relationship between its expression and clinic-pathological variables of endometrial lesions to explore the possibility for CyclinD1 as a potential diagnostic and prognostic marker.

Methods

Cyclin D1 immunohistochemical analysis (IHC) was used to evaluate 201 fixed, paraffin-embedded endometrial samples which included simple hyperplasia (n = 27), atypical complex hyperplasia (ACH) (n = 41), endometrioid carcinoma (n = 103), endometrial serous carcinoma (ESC) (n = 21) and clear cell carcinoma (CCC) (n = 9). A breast cancer with known CyclinD1 expression was selected as a positive control in each immunohistochemistry run. We also performed follow-up study to estimate patients’ prognosis.

Results

CyclinD1 was significantly overexpressed in atypical complex hyperplasia (ACH), endometrioid carcinoma and clear cell carcinoma (CCC). The positive signaling of CyclinD1 was showed less than 40% in simple hyperplasia and endometrial serous carcinoma (ESC). The high expression of CyclinD1 was observed in metastasis carcinoma group more significantly than non-metastasis carcinoma group. Kaplan Meier analysis demonstrated that patients with high CyclinD1 expression had an obviously poor prognosis than patients without CyclinD1 staining (p < 0.05). Moreover, according to multivariate Cox regression analysis, CyclinD1 expression, as crucial as metastasis, was a risk marker for overall survival rate.

Conclusion

CyclinD1 exhibited a promising potential to predict the prognosis of patients with endometrial carcinoma. However, the statistical analysis demonstrated that CyclinD1 exhibited a poor ability to differentiate neoplastic lesions from non-neoplastic lesions; thus, the application of CyclinD1 only is not so credible for differentiation between benign and malignant lesions.

Virtual slides

The virtual slides for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1871063048950173 webcite.

Keywords:
Endometrial cancer; CyclinD1; Prognostic markers; Survival analysis