Investigation of expression of cytokeratins in ESS
Research type
Research Study
Full title
Investigation of expression of cytokeratins in Endometrial Stromal Sarcomas (ESS) bearing JAZF1-SUZ12 and YWHAE-FAM22 genetic aberration.
IRAS ID
189339
Contact name
Siavash Rahimi
Contact email
Sponsor organisation
Portsmouth Hospitals NHS Trust
Duration of Study in the UK
0 years, 3 months, 1 days
Research summary
Endometrial stromal sarcomas (ESS) are gynaecological neoplasms showing diverse morphological appearances and a variety of cellular differentiation and histological patterns. This makes the histological diagnosis of these tumours difficult. The wrong diagnosis may lead to over or under treatment with significant consequences for patients. Additionally, the metastases of ESS may sometimes present a different histological feature from the primary tumour, and in cases showing multiple metastases, different morphology can be observed between metastases. It is worth mentioning, that ESS may have an indolent clinical course and show metastases decades after the surgical treatment of the primary uterine tumour. The diagnosis of ESS is not possible on morphological grounds and requires immunohistochemistry (IHC). ESS has been classified further into two types: high-grade endometrial stromal sarcoma (HG-ESS) and low grade endometrial stromal sarcoma (LG-ESS). However, the diagnostic challenge of ESS is further complicated by their expression of an array of unrelated proteins. Recently, chromosomal aberrations involving JAZF1-SUZ12 at chromosome 7p15.1-p15.2 have been recognized in LG-ESS, and YWHAE-FAM22 fusion t(10;17)(q22;p13) has been linked to HG-ESS. This study is focusing on testing a concept of finding IHC diagnostic markers that can be added to the current diagnostic histopathological pathway to improve histological diagnosis.
Cytokeratins are structural proteins of epithelial cells that form a dense network inside a cell. Such scaffolding gives the epithelial cell ability to sustain stress. Expression of cytokeratins depends on cell type and differentiation status. At present, more than 20 different cytokeratins have been identified. In diagnostic pathology, cytokeratins are used as markers of epithelial differentiation, which are usually utilized to distinguish undifferentiated tumours from carcinomas (epithelial tumours).
There are only few and incomplete reports regarding the expression of cytokeratins in ESS, which also, do not include the full range of commercially available cytokeratins. Therefore, our aim is to investigate expression of cytokeratins in ESS, in order to evaluate their potential, as diagnostic markers. Moreover, the cytokeratin expression has not been previously studied with concomitant molecular analysis of ESS.REC name
Wales REC 6
REC reference
16/WA/0079
Date of REC Opinion
1 Mar 2016
REC opinion
Favourable Opinion