Pathology & Oncology Research

, Volume 25, Issue 1, pp 123–130 | Cite as

Association between Morphological Patterns of Myometrial Invasion and Cancer Stem Cell Markers in Endometrial Endometrioid Carcinoma

  • Ji Y. Park
  • Daegy Hong
  • Ji Young ParkEmail author
Original Article


In endometrial endometrioid adenocarcinoma (EEC), the depth of myometrial invasion (MI) is an important parameter for determining whether additional treatment is warranted. The present study investigated the association between MI patterns, cancer stem cell (CSC) phenotypes, and their clinicopathological significance in EEC. A total of 73 cases of EEC with MI were examined in this study. Haematoxylin and eosin-stained tissue specimens were analysed for MI pattern, which was categorised as infiltrating; expansile; adenomyosis (AM)-like; or microcystic, elongated, and fragmented (MELF)-type. The expression of CSC markers such as cluster of differentiation (CD)44, CD133, and Nanog1, as well as oestrogen receptor (ER) and progesterone receptor (PR) was examined by immunohistochemistry. Clinicopathological features including age, DOI, MI pattern, LVI, lymph node (LN) metastasis, disease progression, and survival outcome were recorded. Most examined cases (45/73) were International Federation of Gynecology and Obstetrics (FIGO) stage I. MI showed infiltrating (49.3%), AM-like (26.3%), MELF (15.1%), and expansile (9.6%) patterns. Tumours with the infiltrating pattern were associated with high FIGO grade (P = 0.002), reduced ER and PR, and CD44 expression (P = 0.014, 0.026, and 0.030, respectively); those with a MELF pattern showed LN metastasis (P < 0.001), lymphovascular invasion (P = 0.011), and reduced ER, CD44, and CD133 expression (P = 0.036, 0.006, and 0.016, respectively). EEC with infiltrating/MELF patterns of MI is associated with worse prognosis. These results suggest that CSC expression profiles are an unfavourable indicator of EEC.


Cancer stem cell marker Epithelial-to-mesenchymal transition Endometrioid carcinoma Myometrial invasion 





cluster of differentiation


endometrial endometrioid carcinoma


oestrogen receptor


cancer stem cells


depth of invasion


epithelial-mesenchymal transition


International Federation of Gynecology and Obstetrics


lymph node.


lymph node involvement.


lower uterine segment.


lymphovascular invasion.


microcystic, elongated, and fragmented.


myometrial invasion.


progesterone receptor.



This work was supported by Biomedical Research Institute grant, Kyungpook National University Hospital (2014).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Arányi Lajos Foundation 2017

Authors and Affiliations

  1. 1.Department of PathologySchool of Medicine, Catholic University of DaeguDaeguSouth Korea
  2. 2.Department of PathologyKyungpook National University Medical Center, Kyungpook National University School of MedicineDaeguSouth Korea
  3. 3.Gynecologic Cancer CenterKyungpook National University Medical Center, Kyungpook National University School of MedicineDaeguSouth Korea

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