Skip to main content
SpringerLink
Log in

Biomarkers in Gynecologic Carcinomas

  • Chapter
  • First Online:
Biomarkers in Carcinoma of Unknown Primary

  • 1300 Accesses

Abstract

Morphological examination of the tumors is the gold standard for diagnosis of the gynecologic tract carcinomas. However, adjunct biomarkers are increasingly utilized in routine pathology practice for the purposes of differential diagnoses and better histologic subclassification of gynecologic tumors as well as to reveal prognostic/predictive and therapeutic benefits for specific treatments. The most commonly used ancillary method is immunohistochemistry (IHC), however, in situ hybridization (ISH) and molecular analysis also have been increasingly used.

In general, cytokeratin profile (CK7, CK20), EMA (epithelial membrane antigen), PAX8 (Mullerian marker), ER (estrogen receptor), PR (progesterone receptor), WT1, p53, p16, IMP3, Ki-67, MMR proteins (MLH1, PMS2, MSH2, MSH6), Napsin A, HNF1β, AMACR, CDX2, SMAD4/DPC4, mCEA, vimentin, SALL4, inhibin-alpha, and calretinin are the most commonly used immunohistochemical stainings for the abovementioned purposes in daily practice. ISH studies, particularly to detect HPVs (human papilloma virus), are also important.

This chapter discusses the utilities and pitfalls of the widely used immunohistochemical staining biomarkers in the context of overlapping morphological features observed in the ovary, fallopian tube, endometrium, cervix, and vulva-vagina carcinomas. Basically, primary carcinomas of these organs and their differential diagnoses have been considered and are summarized in the context of current tumor classification and molecular alterations.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Abdulfatah E, Ahmed Q, Alosh B, et al. Gynecologic cancers: molecular updates 2018. Clin Lab Med. 2018;38:421–38.

    Article  PubMed  Google Scholar 

  2. Leitao MM, Soslow RA, Baergen RN, et al. Mutation and expression of the TP53 gene in early stage epithelial ovarian carcinoma. Gynecol Oncol. 2004;93:301–6.

    Article  CAS  PubMed  Google Scholar 

  3. Vang R, Shih Ie M, Kurman RJ. Ovarian low-grade and high-grade serous carcinoma: pathogenesis, clinicopathologic and molecular biologic features, and diagnostic problems. Adv Anat Pathol. 2009;16:267–82.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Köbel M, Ronnett BM, Singh N, Soslow RA, Gilks CB, McCluggage WG. Interpretation of P53 immunohistochemistry in endometrial carcinomas: toward increased reproducibility. Int J Gynecol Pathol. 2019;38(Suppl 1):S123–31.

    Article  PubMed  Google Scholar 

  5. Kuhn E, Ayhan A. Diagnostic immunohistochemistry in gynaecological neoplasia: a brief survey of the most common scenarios. J Clin Pathol. 2018;71:98–109.

    Article  CAS  PubMed  Google Scholar 

  6. Kandalaft PL, Gown AM. Practical applications in immunohistochemistry: carcinomas of unknown primary site. Arch Pathol Lab Med. 2016;140:508–23.

    Article  CAS  PubMed  Google Scholar 

  7. Hashi A, Yuminamochi T, Murata S, et al. Wilms tumor gene immunoreactivity in primary serous carcinomas of the fallopian tube, ovary, endometrium, and peritoneum. Int J Gynecol Pathol. 2003;22:374–7.

    Article  PubMed  Google Scholar 

  8. Acs G, Pasha T, Zhang PJ. WT1 is differentially expressed in serous, endometrioid, clear cell, and mucinous carcinomas of the peritoneum, fallopian tube, ovary, and endometrium. Int J Gynecol Pathol. 2004;23:110–8.

    Article  PubMed  Google Scholar 

  9. Angelico G, Santoro A, Straccia P, Inzani F, Cianfrini F, Spadola S, Arciuolo D, Valente M, D’Alessandris N, Mulè A, Zannoni GF. Diagnostic and prognostic role of WT1 immunohistochemical expression in uterine carcinoma: a systematic review and meta-analysis across all endometrial carcinoma histotypes. Diagnostics (Basel). 2020;10(9):637. https://doi.org/10.3390/diagnostics10090637.

    Article  CAS  Google Scholar 

  10. Lin X, Lindner JL, Silverman JF, Liu Y. Intestinal type and endocervical-like ovarian mucinous neoplasms are immunophenotypically distinct entities. Appl Immunohistochem Mol Morphol. 2008;16:453–8.

    Article  PubMed  Google Scholar 

  11. Khalique S, Naidoo K, Attygalle AD, et al. Optimised ARID1A immunohistochemistry is an accurate predictor of ARID1A mutational status in gynaecological cancers. J Pathol Clin Res. 2018;4:154–66.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Matias-Guiu X, Stewart CJR. Endometriosis-associated ovarian neoplasia. Pathology. 2018;50:190–204.

    Article  PubMed  Google Scholar 

  13. Yamamoto S, Tsuda H, Aida S, et al. Immunohistochemical detection of hepatocyte nuclear factor 1beta in ovarian and endometrial clear-cell adenocarcinomas and nonneoplastic endometrium. Hum Pathol. 2007;38:1074–80.

    Article  CAS  PubMed  Google Scholar 

  14. Iwamoto M, Nakatani Y, Fugo K, Kishimoto T, Kiyokawa T. Napsin A is frequently expressed in clear cell carcinoma of the ovary and endometrium. Hum Pathol. 2015;46:957–62.

    Article  CAS  PubMed  Google Scholar 

  15. Soong TR, Dinulescu DM, Xian W, Crum CP. Frontiers in the pathology and pathogenesis of ovarian cancer: cancer precursors and “precursor escape”. Hematol Oncol Clin North Am. 2018;32:915–28.

    Article  PubMed  Google Scholar 

  16. Buza N, Hui P. Immunohistochemistry in gynecologic pathology: an example-based practical update. Arch Pathol Lab Med. 2017;141:1052–71.

    Article  CAS  PubMed  Google Scholar 

  17. Cheung AN, Ellenson LH, Gilks CB. Tumours of the ovary. In: WHO classification of Tumours Editorial Board, editor. Female genital tumours. 5th ed. Lyon, France: International Agency for Research on Cancer; 2020. p. 31–167.

    Google Scholar 

  18. Ordóñez NG. Value of PAX8, PAX2, claudin-4, and h-caldesmon immunostaining in distinguishing peritoneal epithelioid mesotheliomas from serous carcinomas. Mod Pathol. 2013;26(4):553–62. https://doi.org/10.1038/modpathol.2012.200. Epub 2012 Nov 30.

    Article  CAS  PubMed  Google Scholar 

  19. Comin CE, Saieva C, Messerini L. h-caldesmon, calretinin, estrogen receptor, and Ber-EP4: a useful combination of immunohistochemical markers for differentiating epithelioid peritoneal mesothelioma from serous papillary carcinoma of the ovary. Am J Surg Pathol. 2007;31(8):1139–48. https://doi.org/10.1097/PAS.0b013e318033e7a8.

    Article  PubMed  Google Scholar 

  20. Chapel DB, Husain AN, Krausz T, McGregor SM. PAX8 expression in a subset of malignant peritoneal mesotheliomas and benign mesothelium has diagnostic implications in the differential diagnosis of ovarian serous carcinoma. Am J Surg Pathol. 2017;41(12):1675–82. https://doi.org/10.1097/PAS.0000000000000935.

    Article  PubMed  Google Scholar 

  21. Chapel DB, Schulte JJ, Husain AN, Krausz T. Application of immunohistochemistry in diagnosis and management of malignant mesothelioma. Transl Lung Cancer Res. 2020;9(Suppl 1):S3–S27. https://doi.org/10.21037/tlcr.2019.11.29.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Naso JR, Tsuji S, Churg A. HEG1 is a highly specific and sensitive marker of epithelioid malignant mesothelioma. Am J Surg Pathol. 2020;44(8):1143–8. https://doi.org/10.1097/PAS.0000000000001469.

    Article  PubMed  Google Scholar 

  23. Ravishankar S, Malpica A, Ramalingam P, Euscher ED. Yolk sac tumor in extragonadal pelvic sites: still a diagnostic challenge. Am J Surg Pathol. 2017;41(1):1–11. https://doi.org/10.1097/PAS.0000000000000722.

    Article  PubMed  Google Scholar 

  24. Fadare O, Zhao C, Khabele D, Parkash V, Quick CM, Gwin K, Desouki MM. Comparative analysis of Napsin A, alpha-methylacyl-coenzyme A racemase (AMACR, P504S), and hepatocyte nuclear factor 1 beta as diagnostic markers of ovarian clear cell carcinoma: an immunohistochemical study of 279 ovarian tumours. Pathology. 2015;47(2):105–11. https://doi.org/10.1097/PAT.0000000000000223.

    Article  CAS  PubMed  Google Scholar 

  25. Ramalingam P, Malpica A, Silva EG, Gershenson DM, Liu JL, Deavers MT. The use of cytokeratin 7 and EMA in differentiating ovarian yolk sac tumors from endometrioid and clear cell carcinomas. Am J Surg Pathol. 2004;28(11):1499–505. https://doi.org/10.1097/01.pas.0000138179.87957.32.

    Article  PubMed  Google Scholar 

  26. Cao D, Guo S, Allan RW, Molberg KH, Peng Y. SALL4 is a novel sensitive and specific marker of ovarian primitive germ cell tumors and is particularly useful in distinguishing yolk sac tumor from clear cell carcinoma. Am J Surg Pathol. 2009;33(6):894–904. https://doi.org/10.1097/PAS.0b013e318198177d.

    Article  PubMed  Google Scholar 

  27. Roma AA, Masand RP. Ovarian Brenner tumors and Walthard nests: a histologic and immunohistochemical study. Hum Pathol. 2014;45(12):2417–22. https://doi.org/10.1016/j.humpath.2014.08.003. Epub 2014 Aug 23.

    Article  CAS  PubMed  Google Scholar 

  28. Logani S, Oliva E, Amin MB, Folpe AL, Cohen C, Young RH. Immunoprofile of ovarian tumors with putative transitional cell (urothelial) differentiation using novel urothelial markers: histogenetic and diagnostic implications. Am J Surg Pathol. 2003;27(11):1434–41. https://doi.org/10.1097/00000478-200311000-00005.

    Article  PubMed  Google Scholar 

  29. Matrai C, Jenkins TM, Baranov E, Schwartz LE. Ovarian mucinous, brenner tumors, and other epithelial tumors. In: Zheng W, Fadare O, Quick CM, editors. Gynecologic and obstetric pathology, vol. 2. Singapore: Springer Nature; 2019. p. 203–30.

    Chapter  Google Scholar 

  30. Euscher ED. Germ cell tumors of the female genital tract. Surg Pathol Clin. 2019;12(2):621–49. https://doi.org/10.1016/j.path.2019.01.005.

    Article  PubMed  Google Scholar 

  31. Low JJ, Ilancheran A, Ng JS. Malignant ovarian germ-cell tumours. Best Pract Res Clin Obstet Gynaecol. 2012;26(3):347–55. https://doi.org/10.1016/j.bpobgyn.2012.01.002. Epub 2012 Feb 1.

    Article  PubMed  Google Scholar 

  32. Nogales FF, Dulcey I, Preda O. Germ cell tumors of the ovary: an update. Arch Pathol Lab Med. 2014;138(3):351–62. https://doi.org/10.5858/arpa.2012-0547-RA.

    Article  PubMed  Google Scholar 

  33. Rabban JT, Zaloudek CJ. A practical approach to immunohistochemical diagnosis of ovarian germ cell tumours and sex cord-stromal tumours. Histopathology. 2013;62(1):71–88. https://doi.org/10.1111/his.12052.

    Article  PubMed  Google Scholar 

  34. Nakopoulou L, Stefanaki K, Janinis J, Mastrominas M. Immunohistochemical expression of placental alkaline phosphatase and vimentin in epithelial ovarian neoplasms. Acta Oncol. 1995;34(4):511–5. https://doi.org/10.3109/02841869509094016.

    Article  CAS  PubMed  Google Scholar 

  35. Esheba GE, Pate LL, Longacre TA. Oncofetal protein glypican-3 distinguishes yolk sac tumor from clear cell carcinoma of the ovary. Am J Surg Pathol. 2008;32(4):600–7. https://doi.org/10.1097/PAS.0b013e31815a565a.

    Article  PubMed  Google Scholar 

  36. Chen H, Quick CM, Fadare O, Zheng W. Germ cell tumors and mixed Germ cell-sex cord-stromal tumors of the ovary. In: Zheng W, Fadare O, Quick CM, editors. Gynecologic and obstetric pathology, vol. 2. Singapore: Springer Nature; 2019. p. 231–72.

    Chapter  Google Scholar 

  37. Young RH. Ovarian sex cord-stromal tumours and their mimics. Pathology. 2018;50(1):5–15. https://doi.org/10.1016/j.pathol.2017.09.007. Epub 2017 Nov 11.

    Article  CAS  PubMed  Google Scholar 

  38. Young RH. Ovarian sex cord-stromal tumors: reflections on a 40-year experience with a fascinating group of tumors, including comments on the seminal observations of Robert E. Scully, MD. Arch Pathol Lab Med. 2018;142(12):1459–84. https://doi.org/10.5858/arpa.2018-0291-RA.

    Article  CAS  PubMed  Google Scholar 

  39. Kaspar HG, Crum CP. The utility of immunohistochemistry in the differential diagnosis of gynecologic disorders. Arch Pathol Lab Med. 2015;139:39–54.

    Article  PubMed  Google Scholar 

  40. McCluggage WG, McKenna M, McBride HA. CD56 is a sensitive and diagnostically useful immunohistochemical marker of ovarian sex cord-stromal tumors. Int J Gynecol Pathol. 2007;26(3):322–7. https://doi.org/10.1097/01.pgp.0000236947.59463.87.

    Article  PubMed  Google Scholar 

  41. Hanley KZ, Mosunjac MB. Practical review of ovarian sex cord-stromal tumors. Surg Pathol Clin. 2019;12(2):587–620. https://doi.org/10.1016/j.path.2019.02.005.

  42. Tischkowitz M, Huang S, Banerjee S, Hague J, Hendricks WPD, Huntsman DG, Lang JD, Orlando KA, Oza AM, Pautier P, Ray-Coquard I, Trent JM, Witcher M, Witkowski L, McCluggage WG, Levine DA, Foulkes WD, Weissman BE. Small-cell carcinoma of the ovary, hypercalcemic type-genetics, new treatment targets, and current management guidelines. Clin Cancer Res. 2020;26(15):3908–17. https://doi.org/10.1158/1078-0432.CCR-19-3797. Epub 2020 Mar 10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Witkowski L, Goudie C, Foulkes WD, McCluggage WG. Small-cell carcinoma of the ovary of hypercalcemic type (malignant Rhabdoid tumor of the ovary): a review with recent developments on pathogenesis. Surg Pathol Clin. 2016;9(2):215–26. https://doi.org/10.1016/j.path.2016.01.005.

    Article  PubMed  Google Scholar 

  44. McCluggage WG, Witkowski L, Clarke BA, Foulkes WD. Clinical, morphological and immunohistochemical evidence that small-cell carcinoma of the ovary of hypercalcaemic type (SCCOHT) may be a primitive germ-cell neoplasm. Histopathology. 2017;70(7):1147–54. https://doi.org/10.1111/his.13177. Epub 2017 Mar 20.

    Article  PubMed  Google Scholar 

  45. Lisio MA, Fu L, Goyeneche A, Gao ZH, Telleria C. High-grade serous ovarian cancer: basic sciences, clinical and therapeutic standpoints. Int J Mol Sci. 2019;20(4):952. https://doi.org/10.3390/ijms20040952.

    Article  CAS  PubMed Central  Google Scholar 

  46. Soslow RA, Han G, Park KJ, Garg K, Olvera N, Spriggs DR, Kauff ND, Levine DA. Morphologic patterns associated with BRCA1 and BRCA2 genotype in ovarian carcinoma. Mod Pathol. 2012;25(4):625–36. https://doi.org/10.1038/modpathol.2011.183. Epub 2011 Dec 23.

    Article  CAS  PubMed  Google Scholar 

  47. Huang X-z, Jia H, Xiao Q, Li R-z, Wang X-s, Yin H-y, Zhou X. Efficacy and prognostic factors for PARP inhibitors in patients with ovarian cancer. Front Oncol. 2020;10:958. Published online 2020 Jun 16. https://doi.org/10.3389/fonc.2020.00958.

    Article  PubMed  PubMed Central  Google Scholar 

  48. El-Deiry WS, Goldberg RM, Lenz HJ, Shields AF, Gibney GT, Tan AR, Brown J, Eisenberg B, Heath EI, Phuphanich S, Kim E, Brenner AJ, Marshall JL. The current state of molecular testing in the treatment of patients with solid tumors, 2019. CA Cancer J Clin. 2019;69(4):305–43. https://doi.org/10.3322/caac.21560. Epub 2019 May 22.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Selves J, Long-Mira E, Mathieu MC, Rochaix P, Ilie M. Immunohistochemistry for diagnosis of metastatic carcinomas of unknown primary site. Cancers. 2018;10(4):108.

    Article  PubMed Central  Google Scholar 

  50. Kalampokas E, Payne F, Gurumurthy M. An update on the use of immunohistochemistry and molecular pathology in the diagnosis of pre-invasive and malignant lesions in gynecological oncology. Gynecol Oncol. 2018;150:378–86.

    Article  CAS  PubMed  Google Scholar 

  51. Hirsch MS, Watkins J. A comprehensive review of biomarker use in the gynecologic tract including differential diagnoses and diagnostic pitfalls. Adv Anat Pathol. 2020;27(3):164–92. https://doi.org/10.1097/PAP.0000000000000238.

    Article  PubMed  Google Scholar 

  52. Köbel M, Rahimi K, Rambau PF, Naugler C, Le Page C, Meunier L, de Ladurantaye M, Lee S, Leung S, Goode EL, Ramus SJ, Carlson JW, Li X, Ewanowich CA, Kelemen LE, Vanderhyden B, Provencher D, Huntsman D, Lee CH, Gilks CB, Mes Masson AM. An immunohistochemical algorithm for ovarian carcinoma typing. Int J Gynecol Pathol. 2016;35(5):430–41. https://doi.org/10.1097/PGP.0000000000000274.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Koelma IA, Nap M, Rodenburg CJ, Fleuren GJ. The value of tumour marker CA 125 in surgical pathology. Histopathology. 1987;11:287–94.

    Article  CAS  PubMed  Google Scholar 

  54. Keen CE, Szakacs S, Okon E, Rubin JS, Bryant BM. CA125 and thyroglobulin staining in papillary carcinomas of thyroid and ovarian origin is not completely specific for site of origin. Histopathology. 1999;34:113–7.

    Article  CAS  PubMed  Google Scholar 

  55. Berg KB, Schaeffer DF. SATB2 as an immunohistochemical marker for colorectal adenocarcinoma: a concise review of benefits and pitfalls. Arch Pathol Lab Med. 2017;141(10):1428–33. https://doi.org/10.5858/arpa.2016-0243-RS.

    Article  CAS  PubMed  Google Scholar 

  56. McCluggage WG. Immunohistochemistry in the distinction between primary and metastatic ovarian mucinous neoplasms. J Clin Pathol. 2012;65:596–600.

    Article  PubMed  Google Scholar 

  57. Ritterhouse LL, Wu EY, Kim WG, Dillon DA, Hirsch MS, Sholl LM, Agoston AT, Setia N, Lauwers GY, Park DY, Srivastava A, Doyle LA. Loss of SMAD4 protein expression in gastrointestinal and extra-gastrointestinal carcinomas. Histopathology. 2019;75(4):546–51. https://doi.org/10.1111/his.13894. Epub 2019 Aug 13.

    Article  PubMed  Google Scholar 

  58. Carrick K, Zheng W. Secondary tumors of the ovary. In: Zheng W, Fadare O, Quick CM, editors. Gynecologic and obstetric pathology, vol. 2. Singapore: Springer Nature; 2019. p. 323–67.

    Chapter  Google Scholar 

  59. Singh N, Benson JL, Gan C, Anglesio M, Arora R, Faruqi AZ, Hirschowitz L, Kommoss F, Scott K, Trevisan G, Leen SLS, Wilkinson N, Gilks CB, McCluggage WG. Disease distribution in low-stage tubo-ovarian high-grade serous carcinoma (HGSC): implications for assigning primary site and FIGO stage. Int J Gynecol Pathol. 2018;37(4):324–30. https://doi.org/10.1097/PGP.0000000000000429.

    Article  PubMed  Google Scholar 

  60. Soong TR, Kolin DL, Teschan NJ, Crum CP. Back to the future? The fallopian tube, precursor escape and a dualistic model of high-grade serous carcinogenesis. Cancers (Basel). 2018;10(12):468. https://doi.org/10.3390/cancers10120468.

    Article  CAS  Google Scholar 

  61. Cheung AN, Matias-Guiu X. Tumours of the fallopian tube. In: WHO classification of Tumours Editorial Board, editor. Female genital tumours. 5th ed. Lyon, France: International Agency for Research on Cancer; 2020. p. 215–31.

    Google Scholar 

  62. Kolin DL, Nucci MR. Fallopian tube neoplasia and mimics. Surg Pathol Clin. 2019;12(2):457–79. https://doi.org/10.1016/j.path.2019.01.006.

    Article  PubMed  Google Scholar 

  63. Shalaby A, Shenoy V. Female adnexal tumor of probable Wolffian origin: a review. Arch Pathol Lab Med. 2020;144(1):24–8. https://doi.org/10.5858/arpa.2019-0152-RA. Epub 2019 Aug 30.

    Article  CAS  PubMed  Google Scholar 

  64. Bokhman JV. Two pathogenetic types of endometrial carcinoma. Gynecol Oncol. 1983;15(1):10–7. https://doi.org/10.1016/0090-8258(83)90111-7.

    Article  CAS  PubMed  Google Scholar 

  65. Kandoth C, Schultz N, Cherniack AD, et al., The Cancer Genome Atlas (TCGA) Research Network. Integrated genomic characterization of endometrial carcinoma. Nature. 2013;497:67–73.

    Google Scholar 

  66. Vermij L, Smit V, Nout R, Bosse T. Incorporation of molecular characteristics into endometrial cancer management. Histopathology. 2020;76(1):52–63. https://doi.org/10.1111/his.14015.

    Article  PubMed  Google Scholar 

  67. https://documents.cap.org/protocols/cp-femalereproductive-endometrium-biomarker-19-1201.pdf.

  68. Mills AM, Liou S, Ford JM, Berek JS, Pai RK, Longacre TA. Lynch syndrome screening should be considered for all patients with newly diagnosed endometrial cancer. Am J Surg Pathol. 2014;38(11):1501–9. https://doi.org/10.1097/PAS.0000000000000321.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Mills AM, Longacre TA. Lynch syndrome screening in the gynecologic tract: current state of the art. Am J Surg Pathol. 2016;40(4):e35–44. https://doi.org/10.1097/PAS.0000000000000608.

    Article  PubMed  Google Scholar 

  70. Newton K, Jorgensen NM, Wallace AJ, Buchanan DD, Lalloo F, McMahon RF, Hill J, Evans DG. Tumour MLH1 promoter region methylation testing is an effective prescreen for Lynch Syndrome (HNPCC). J Med Genet. 2014;51(12):789–96. https://doi.org/10.1136/jmedgenet-2014-102552. Epub 2014 Oct 3.

    Article  CAS  PubMed  Google Scholar 

  71. Lucas E, Chen H, Molberg K, Castrillon DH, Rivera Colon G, Li L, Hinson S, Thibodeaux J, Lea J, Miller DS, Zheng W. Mismatch repair protein expression in endometrioid intraepithelial neoplasia/atypical hyperplasia: should we screen for Lynch syndrome in precancerous lesions? Int J Gynecol Pathol. 2019;38(6):533–42. https://doi.org/10.1097/PGP.0000000000000557.

    Article  CAS  PubMed  Google Scholar 

  72. Syngal S, Gruber SB. Calculation of risk of colorectal and endometrial cancer among patients with Lynch syndrome. Gastroenterology. 2009;137(5):1621–7. https://doi.org/10.1053/j.gastro.2009.07.039. Epub 2009 Jul 18.

    Article  PubMed  Google Scholar 

  73. Wang Y, Wang Y, Li J, Cragun J, Hatch K, Chambers SK, Zheng W. Lynch syndrome related endometrial cancer: clinical significance beyond the endometrium. J Hematol Oncol. 2013;6:22. https://doi.org/10.1186/1756-8722-6-22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  74. Mills AM. Endometrial carcinoma. In: Zheng W, Fadare O, Quick CM, editors. Gynecologic and obstetric pathology, vol. 1. Singapore: Springer Nature; 2019. p. 455–514.

    Chapter  Google Scholar 

  75. Hoang LN, McConechy MK, Köbel M, Han G, Rouzbahman M, Davidson B, Irving J, Ali RH, Leung S, McAlpine JN, Oliva E, Nucci MR, Soslow RA, Huntsman DG, Gilks CB, Lee CH. Histotype-genotype correlation in 36 high-grade endometrial carcinomas. Am J Surg Pathol. 2013;37(9):1421–32. https://doi.org/10.1097/PAS.0b013e31828c63ed.

    Article  PubMed  Google Scholar 

  76. Heckl M, Schmoeckel E, Hertlein L, Rottmann M, Jeschke U, Mayr D. The ARID1A, p53 and ß-Catenin statuses are strong prognosticators in clear cell and endometrioid carcinoma of the ovary and the endometrium. PLoS One. 2018;13(2):e0192881. https://doi.org/10.1371/journal.pone.0192881. eCollection 2018.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  77. Murali R, Delair DF, Bean SM, Abu-Rustum NR, Soslow RA. Evolving roles of histologic evaluation and molecular/genomic profiling in the management of endometrial cancer. J Natl Compr Canc Netw. 2018;16(2):201–9. https://doi.org/10.6004/jnccn.2017.7066.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  78. Gilks CB, Oliva E, Soslow R. Poor interobserver reproducibility in the diagnosis of high-grade endometrial carcinoma. Am J Surg Pathol. 2013;37(6):874–81.

    Article  PubMed  Google Scholar 

  79. Lomo L, Nucci MR, Lee KR, et al. Histologic and immunohistochemical decision making in endometrial adenocarcinoma. Mod Pathol. 2008;21(8):937–42.

    Article  PubMed  Google Scholar 

  80. Hoang LN, Han G, McConechy M, et al. Immunohistochemical characterization of prototypical endometrial clear cell carcinoma—diagnostic utility of HNF-1b and oestrogen receptor. Histopathology. 2014;64(4):585–96.

    Article  PubMed  Google Scholar 

  81. Fadare O, Gwin K, Desouki MM, Crispens MA, Jones HW III, Khabele D, Liang SX, Zheng W, Mohammed K, Hecht JL, Parkash V. The clinicopathologic significance of p53 and BAF-250a (ARID1A) expression in clear cell carcinoma of the endometrium. Mod Pathol. 2013;26(8):1101–10. https://doi.org/10.1038/modpathol.2013.35. Epub 2013 Mar 22.

    Article  CAS  PubMed  Google Scholar 

  82. Sanderson PA, Critchley HO, Williams AR, Arends MJ, Saunders PT. New concepts for an old problem: the diagnosis of endometrial hyperplasia. Hum Reprod Update. 2017;23(2):232–54. https://doi.org/10.1093/humupd/dmw042.

    Article  PubMed  Google Scholar 

  83. Zheng W, Baker HE, Mutter GL. Involution of PTEN-null endometrial glands with progestin therapy. Gynecol Oncol. 2004;92(3):1008–13. https://doi.org/10.1016/j.ygyno.2003.11.026.

    Article  PubMed  Google Scholar 

  84. Monte NM, Webster KA, Neuberg D, Dressler GR, Mutter GL. Joint loss of PAX2 and PTEN expression in endometrial precancers and cancer. Cancer Res. 2010;70(15):6225–32. https://doi.org/10.1158/0008-5472.CAN-10-0149. Epub 2010 Jul 14.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  85. Mutter GL, Monte NM, Neuberg D, Ferenczy A, Eng C. Emergence, involution, and progression to carcinoma of mutant clones in normal endometrial tissues. Cancer Res. 2014;74(10):2796–802. https://doi.org/10.1158/0008-5472.CAN-14-0108. Epub 2014 Mar 24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  86. Goebel EA, Vidal A, Matias-Guiu X, Blake Gilks C. The evolution of endometrial carcinoma classification through application of immunohistochemistry and molecular diagnostics: past, present and future. Virchows Arch. 2018;472(6):885–96. https://doi.org/10.1007/s00428-017-2279-8. Epub 2017 Dec 12.

    Article  PubMed  Google Scholar 

  87. Pallares J, Bussaglia E, Martínez-Guitarte JL, Dolcet X, Llobet D, Rue M, Sanchez-Verde L, Palacios J, Prat J, Matias-Guiu X. Immunohistochemical analysis of PTEN in endometrial carcinoma: a tissue microarray study with a comparison of four commercial antibodies in correlation with molecular abnormalities. Mod Pathol. 2005;18(5):719–27. https://doi.org/10.1038/modpathol.3800347.

    Article  CAS  PubMed  Google Scholar 

  88. Chen H, Lucas E, Strickland AL, Carrick K, Gwin K, Castrillon DH, Rivera-Colon G, Niu S, Molberg KH, Zheng W. Specific biomarker expression patterns in the diagnosis of residual and recurrent endometrial precancers after progestin treatment: a longitudinal study. Am J Surg Pathol. 2020;44(10):1429–39. https://doi.org/10.1097/PAS.0000000000001537.

    Article  PubMed  Google Scholar 

  89. Leskela S, Pérez-Mies B, Rosa-Rosa JM, Cristobal E, Biscuola M, Palacios-Berraquero ML, Ong S, Matias-Guiu Guia X, Palacios J. Molecular basis of tumor heterogeneity in endometrial carcinosarcoma. Cancers (Basel). 2019;11(7):964. https://doi.org/10.3390/cancers11070964.

    Article  CAS  Google Scholar 

  90. Cherniack AD, Shen H, Walter V, Stewart C, Murray BA, Bowlby R, Hu X, Ling S, Soslow RA, Broaddus RR, Zuna RE, Robertson G, Laird PW, Kucherlapati R, Mills GB, Cancer Genome Atlas Research Network, Weinstein JN, Zhang J, Akbani R, Levine DA. Integrated molecular characterization of uterine carcinosarcoma. Cancer Cell. 2017;31(3):411–23. https://doi.org/10.1016/j.ccell.2017.02.010.

  91. Euscher ED, Bassett R, Duose DY, Lan C, Wistuba I, Ramondetta L, Ramalingam P, Malpica A. Mesonephric-like carcinoma of the endometrium: a subset of endometrial carcinoma with an aggressive behavior. Am J Surg Pathol. 2020;44(4):429–43. https://doi.org/10.1097/PAS.0000000000001401.

    Article  PubMed  Google Scholar 

  92. Pors J, Cheng A, Leo JM, Kinloch MA, Gilks B, Hoang L. A comparison of GATA3, TTF1, CD10, and calretinin in identifying mesonephric and mesonephric-like carcinomas of the gynecologic tract. Am J Surg Pathol. 2018;42(12):1596–606. https://doi.org/10.1097/PAS.0000000000001142.

    Article  PubMed  Google Scholar 

  93. Brachtel EF, Sánchez-Estevez C, Moreno-Bueno G, Prat J, Palacios J, Oliva E. Distinct molecular alterations in complex endometrial hyperplasia (CEH) with and without immature squamous metaplasia (squamous morules). Am J Surg Pathol. 2005;29(10):1322–9. https://doi.org/10.1097/01.pas.0000171001.87599.e2.

    Article  PubMed  Google Scholar 

  94. Houghton O, Connolly LE, McCluggage WG. Morules in endometrioid proliferations of the uterus and ovary consistently express the intestinal transcription factor CDX2. Histopathology. 2008;53(2):156–65. https://doi.org/10.1111/j.1365-2559.2008.03083.x.

    Article  CAS  PubMed  Google Scholar 

  95. Blanco LZ Jr, Heagley DE, Lee JC, Gown AM, Gattuso P, Rotmensch J, Guirguis A, Dewdney S, Bitterman P. Immunohistochemical characterization of squamous differentiation and morular metaplasia in uterine endometrioid adenocarcinoma. Int J Gynecol Pathol. 2013;32(3):283–92. https://doi.org/10.1097/PGP.0b013e31826129e1.

    Article  CAS  PubMed  Google Scholar 

  96. Liang SX, Patel K, Pearl M, Liu J, Zheng W, Tornos C. Sertoliform endometrioid carcinoma of the endometrium with dual immunophenotypes for epithelial membrane antigen and inhibin alpha: case report and literature review. Int J Gynecol Pathol. 2007;26(3):291–7. https://doi.org/10.1097/01.pgp.0000236948.67087.56.

    Article  PubMed  Google Scholar 

  97. Srodon M, Klein WM, Kurman RJ. CD10 immunostaining does not distinguish endometrial carcinoma invading myometrium from carcinoma involving adenomyosis. Am J Surg Pathol. 2003;27(6):786–9. https://doi.org/10.1097/00000478-200306000-00009.

    Article  PubMed  Google Scholar 

  98. Glandular P-HC. Neoplasia of the uterine cervix and its related lesions. In: Zheng W, Fadare O, Quick CM, editors. Gynecologic and obstetric pathology, vol. 1. Singapore: Springer Nature; 2019. p. 325–68.

    Google Scholar 

  99. Stewart CJ, Crook ML. PAX2 and cyclin D1 expression in the distinction between cervical microglandular hyperplasia and endometrial microglandular-like carcinoma: a comparison with p16, vimentin, and Ki67. Int J Gynecol Pathol. 2015;34(1):90–100. https://doi.org/10.1097/PGP.0000000000000107.

    Article  CAS  PubMed  Google Scholar 

  100. Qiu W, Mittal K. Comparison of morphologic and immunohistochemical features of cervical microglandular hyperplasia with low-grade mucinous adenocarcinoma of the endometrium. Int J Gynecol Pathol. 2003;22(3):261–5. https://doi.org/10.1097/01.PGP.0000071043.12278.8D.

    Article  PubMed  Google Scholar 

  101. Ip PCC, Wang Y, Cheung ANY. Complications of early pregnancy and gestational trophoblastic diseases. In: Zheng W, Fadare O, Quick CM, editors. Gynecologic and obstetric pathology, vol. 2. Singapore: Springer Nature; 2019. p. 427–57.

    Chapter  Google Scholar 

  102. Stoffel E, Mukherjee B, Raymond VM, Tayob N, Kastrinos F, Sparr J, Wang F, Bandipalliam P, Syngal S, Gruber SB. Calculation of risk of colorectal and endometrial cancer among patients with Lynch syndrome. Gastroenterology. 2009;137(5):1621–7. https://doi.org/10.1053/j.gastro.2009.07.039. Epub 2009 Jul 18.

    Article  PubMed  Google Scholar 

  103. Cho KR, Cooper K, Croce S, Djordevic B, Herrington S, Howitt B, Hui P, Ip P, Koebel M, Lax S, Quade BJ, Shaw P, Vidal A, Yemelyanova A, Clarke B, Hedrick Ellenson L, Longacre TA, Shih IM, McCluggage WG, Malpica A, Oliva E, Parkash V, Matias-Guiu X. International Society of Gynecological Pathologists (ISGyP) Endometrial Cancer Project: guidelines from the special techniques and Ancillary Studies Group. Int J Gynecol Pathol. 2019;38(Suppl 1):S114–22. https://doi.org/10.1097/PGP.0000000000000496.

    Article  PubMed  Google Scholar 

  104. https://www.nccn.org/professionals/physician_gls/pdf/uterine.pdf (Version 1-2021).

  105. Zheng W, Yi X, Fadare O, Liang SX, Martel M, Schwartz PE, Jiang Z. The oncofetal protein IMP3: a novel biomarker for endometrial serous carcinoma. Am J Surg Pathol. 2008;32(2):304–15. https://doi.org/10.1097/PAS.0b013e3181483ff8.

    Article  PubMed  Google Scholar 

  106. Herrington CS, Ordi J, Bray F. Tumours of the uterine cervix. In: WHO Classification of Tumours, Editorial Board, editor. Female genital tumours [Internet], WHO classification of tumours series, vol. 4. 5th ed. Lyon, France: International Agency for Research on Cancer; 2020.

    Google Scholar 

  107. Huang EC, Xing D. Cervical squamous neoplasia. In: Zheng W, Fadare O, Quick CM, editors. Gynecologic and obstetric pathology, vol. 1. Singapore: Springer Nature; 2019. p. 293–324.

    Chapter  Google Scholar 

  108. van Baars R, van der Marel J, Snijders PJ, Rodriquez-Manfredi A, ter Harmsel B, van den Munckhof HA, Ordi J, del Pino M, van de Sandt MM, Wentzensen N, Meijer CJ, Quint WG. CADM1 and MAL methylation status in cervical scrapes is representative of the most severe underlying lesion in women with multiple cervical biopsies. Int J Cancer. 2016;138(2):463–71. https://doi.org/10.1002/ijc.29706. Epub 2015 Aug 14.

    Article  CAS  PubMed  Google Scholar 

  109. https://documents.cap.org/protocols/cp-gynecologic-uterinecervix-resection-20-5000.pdf.

  110. Nicolás I, Marimon L, Barnadas E, Saco A, Rodríguez-Carunchio L, Fusté P, Martí C, Rodriguez-Trujillo A, Torne A, Del Pino M, Ordi J. HPV-negative tumors of the uterine cervix. Mod Pathol. 2019;32(8):1189–96. https://doi.org/10.1038/s41379-019-0249-1. Epub 2019 Mar.

    Article  CAS  PubMed  Google Scholar 

  111. Mills AM, Dirks DC, Poulter MD, Mills SE, Stoler MH. HR-HPV E6/E7 mRNA in situ hybridization: validation against PCR, DNA in situ hybridization, and p16 immunohistochemistry in 102 samples of cervical, vulvar, anal, and head and neck neoplasia. Am J Surg Pathol. 2017;41(5):607–15. https://doi.org/10.1097/PAS.0000000000000800.

    Article  PubMed  Google Scholar 

  112. Mills AM, Coppock JD, Willis BC, Stoler MH. HPV E6/E7 mRNA in situ hybridization in the diagnosis of cervical low-grade squamous intraepithelial lesions (LSIL). Am J Surg Pathol. 2018;42(2):192–200. https://doi.org/10.1097/PAS.0000000000000974.

    Article  PubMed  Google Scholar 

  113. Duvlis S, Popovska-Jankovic K, Arsova ZS, Memeti S, Popeska Z, Plaseska-Karanfilska D. HPV E6/E7 mRNA versus HPV DNA biomarker in cervical cancer screening of a group of Macedonian women. J Med Virol. 2015;87(9):1578–86. https://doi.org/10.1002/jmv.24199. Epub 2015 Apr 16.

    Article  CAS  PubMed  Google Scholar 

  114. Laudadio J. Human papillomavirus detection: testing methodologies and their clinical utility in cervical cancer screening. Adv Anat Pathol. 2013;20(3):158–67. https://doi.org/10.1097/PAP.0b013e31828d1893.

    Article  CAS  PubMed  Google Scholar 

  115. Stolnicu S, Barsan I, Hoang L, Patel P, Terinte C, Pesci A, Aviel-Ronen S, Kiyokawa T, Alvarado-Cabrero I, Pike MC, Oliva E, Park KJ, Soslow RA. International Endocervical Adenocarcinoma Criteria and Classification (IECC): a new pathogenetic classification for invasive adenocarcinomas of the endocervix. Am J Surg Pathol. 2018;42(2):214–26. https://doi.org/10.1097/PAS.0000000000000986.

    Article  PubMed  PubMed Central  Google Scholar 

  116. Hodgson A, Park KJ. Cervical adenocarcinomas: a heterogeneous group of tumors with variable etiologies and clinical outcomes. Arch Pathol Lab Med. 2019;143(1):34–46. https://doi.org/10.5858/arpa.2018-0259-RA.

    Article  PubMed  Google Scholar 

  117. Stolnicu S, Barsan I, Hoang L, Patel P, Chiriboga L, Terinte C, Pesci A, Aviel-Ronen S, Kiyokawa T, Alvarado-Cabrero I, Pike MC, Oliva E, Park KJ, Soslow RA. Diagnostic algorithmic proposal based on comprehensive immunohistochemical evaluation of 297 invasive endocervical adenocarcinomas. Am J Surg Pathol. 2018;42(8):989–1000. https://doi.org/10.1097/PAS.0000000000001090.

    Article  PubMed  PubMed Central  Google Scholar 

  118. McCluggage WG, Shah R, Connolly LE, McBride HA. Intestinal-type cervical adenocarcinoma in situ and adenocarcinoma exhibit a partial enteric immunophenotype with consistent expression of CDX2. Int J Gynecol Pathol. 2008;27(1):92–100. https://doi.org/10.1097/pgp.0b013e31815698e7.

    Article  CAS  PubMed  Google Scholar 

  119. Park KJ. Cervical adenocarcinoma: integration of HPV status, pattern of invasion, morphology and molecular markers into classification. Histopathology. 2020;76(1):112–27. https://doi.org/10.1111/his.13995.

    Article  PubMed  Google Scholar 

  120. Herrington CS, Kim K-R, McCluggage WG, Ordi J. Tumours of the vulva. In: WHO Classification of Tumours Editorial Board, editor. Female genital tumours. 5th ed. Lyon, France: International Agency for Research on Cancer; 2020. p. 419–50.

    Google Scholar 

  121. Singh N, Gilks CB. Vulval squamous cell carcinoma and its precursors. Histopathology. 2020;76(1):128–38. https://doi.org/10.1111/his.13989.

    Article  PubMed  Google Scholar 

  122. Protocol for the examination of specimens from patients with primary carcinoma of the vulva. https://documents.cap.org/protocols/cp-femalereproductive-vulva-20-4101.pdf. Version: Vulva 4.1.0.1.

  123. Rakislova N, Clavero O, Alemany L, Saco A, Quirós B, Lloveras B, Alejo M, Pawlita M, Quint W, Del Pino M, de Sanjose S, Ordi J, VVAP Study Group. Histological characteristics of HPV-associated and -independent squamous cell carcinomas of the vulva: a study of 1,594 cases. Int J Cancer. 2017;141(12):2517–27. https://doi.org/10.1002/ijc.31006. Epub 2017 Aug 31.

    Article  CAS  PubMed  Google Scholar 

  124. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424. https://doi.org/10.3322/caac.21492. Epub 2018 Sep 12.

    Article  PubMed  Google Scholar 

  125. Herrington CS, Kim K-R, Kong CS, McCluggage WG, Ordi J. Tumours of the vagina. In: WHO Classification of Tumours Editorial Board, editor. Female genital tumours. 5th ed. Lyon, France: International Agency for Research on Cancer; 2020. p. 391–418.

    Google Scholar 

  126. Alemany L, Saunier M, Tinoco L, Quirós B, Alvarado-Cabrero I, Alejo M, Joura EA, Maldonado P, Klaustermeier J, Salmerón J, Bergeron C, Petry KU, Guimerà N, Clavero O, Murillo R, Clavel C, Wain V, Geraets DT, Jach R, Cross P, Carrilho C, Molina C, Shin HR, Mandys V, Nowakowski AM, Vidal A, Lombardi L, Kitchener H, Sica AR, Magaña-León C, Pawlita M, Quint W, Bravo IG, Muñoz N, de Sanjosé S, Bosch FX, HPV VVAP Study Group, et al. Eur J Cancer. 2014;50(16):2846–54. https://doi.org/10.1016/j.ejca.2014.07.018. Epub 2014 Aug 21.

    Article  CAS  PubMed  Google Scholar 

  127. de Martel C, Plummer M, Vignat J, Franceschi S. Worldwide burden of cancer attributable to HPV by site, country and HPV type. Int J Cancer. 2017;141(4):664–70. https://doi.org/10.1002/ijc.30716. Epub 2017 Jun 8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  128. De Vuyst H, Clifford GM, Nascimento MC, Madeleine MM, Franceschi S. Prevalence and type distribution of human papillomavirus in carcinoma and intraepithelial neoplasia of the vulva, vagina and anus: a meta-analysis. Int J Cancer. 2009;124(7):1626–36. https://doi.org/10.1002/ijc.24116.

    Article  CAS  PubMed  Google Scholar 

  129. Talia KL, Wong RW, McCluggage WG. Expression of markers of Müllerian clear cell carcinoma in primary cervical and vaginal gastric-type adenocarcinomas. Int J Gynecol Pathol. 2019;38(3):276–82. https://doi.org/10.1097/PGP.0000000000000529.

    Article  PubMed  Google Scholar 

  130. Cree IA, Malpica A, McCluggage WG. Neuroendocrine neoplasia. In: WHO Classification of Tumours Editorial Board, editor. Female genital tumours. 5th ed. Lyon, France: International Agency for Research on Cancer; 2020. p. 451–9.

    Google Scholar 

  131. Howitt BE, Kelly P, McCluggage WG. Pathology of neuroendocrine tumours of the female genital tract. Curr Oncol Rep. 2017;19(9):59. https://doi.org/10.1007/s11912-017-0617-2.

    Article  PubMed  Google Scholar 

  132. Howitt BE, Dong F, Vivero M, Shah V, Lindeman N, Schoolmeester JK, Baltay M, MacConaill L, Sholl LM, Nucci MR, McCluggage WG. Molecular characterization of neuroendocrine carcinomas of the endometrium: representation in all 4 TCGA groups. Am J Surg Pathol. 2020;44(11):1541–8. https://doi.org/10.1097/PAS.0000000000001560.

    Article  PubMed  Google Scholar 

  133. Mazur MT, Hsueh S, Gersell DJ. Metastases to the female genital tract. Analysis of 325 cases. Cancer. 1984;53:1978–84.

    Article  CAS  PubMed  Google Scholar 

  134. Kumar NB, Hart WR. Metastases to the uterine corpus from extragenital cancers. Cancer. 1982;50:2163–9.

    Article  CAS  PubMed  Google Scholar 

  135. Stemmermann GN. Extrapelvic carcinoma metastatic to the uterus. Am J Obstet Gynecol. 1961;82:1261–6.

    Article  CAS  PubMed  Google Scholar 

  136. Taxy JB, Trujillo YP. Breast cancer metastatic to the uterus. Clinical manifestations of a rare event. Arch Pathol Lab Med. 1994;118:819–21.

    CAS  PubMed  Google Scholar 

  137. Imachi M, Tsukamoto N, Amagase H, et al. Metastatic adenocarcinoma to the uterine cervix from gastric cancer. A clinicopathologic analysis of 16 cases. Cancer. 1993;71:3472–7.

    Article  CAS  PubMed  Google Scholar 

  138. Lemoine NR, Hall PA. Epithelial tumors metastatic to the uterine cervix. A study of 33 cases and review of the literature. Cancer. 1986;57:2002–5.

    Article  CAS  PubMed  Google Scholar 

  139. Dehner LP. Metastatic and secondary tumors of the vulva. Obstet Gynecol. 1973;42:47–57.

    CAS  PubMed  Google Scholar 

  140. Nerdrum TA. Vaginal metastasis of hypernephroma. Report of three cases. Acta Obstet Gynecol Scand. 1966;45:515–24.

    Article  CAS  PubMed  Google Scholar 

  141. Stander RW. Vaginal metastases following treatment of endometrial carcinoma. Am J Obstet Gynecol. 1956;71:776–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Molecular Pathology, Graduate School of Health Sciences, Dokuz Eylul University, Izmir, Turkey

    Canan Kelten Talu & Emine Cagnur Ulukus

  2. Department of Pathology, University of Health Sciences, Izmir Faculty of Medicine, Izmir, Turkey

    Canan Kelten Talu

  3. Department of Pathology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey

    Emine Cagnur Ulukus

  4. Department of Pathology, UT Southwestern Medical Center, Dallas, TX, USA

    Wenxin Zheng

Authors
  1. Canan Kelten Talu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Emine Cagnur Ulukus
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wenxin Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Canan Kelten Talu .

Editor information

Editors and Affiliations

  1. Department of Molecular Pathology, Graduate School of Health Sciences, Dokuz Eylul University, İzmir, Turkey

    Sulen Sarioglu

  2. Department of Molecular Pathology, Graduate School of Health Sciences, Dokuz Eylul University, İzmir, Turkey

    Ozgul Sagol

  3. Department of Molecular Pathology, Graduate School of Health Sciences, Dokuz Eylul University, İzmir, Turkey

    Anil Aysal

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Talu, C.K., Ulukus, E.C., Zheng, W. (2022). Biomarkers in Gynecologic Carcinomas. In: Sarioglu, S., Sagol, O., Aysal, A. (eds) Biomarkers in Carcinoma of Unknown Primary. Springer, Cham. https://doi.org/10.1007/978-3-030-84432-5_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-84432-5_10

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-84431-8

  • Online ISBN: 978-3-030-84432-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation