{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T23:27:33Z","timestamp":1783466853536,"version":"3.55.0"},"reference-count":42,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T00:00:00Z","timestamp":1687737600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Lega Italiana per la Lotta contro i Tumori-LILT-Bando 5 \u00d7 1000 anno 2019"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Endometrial cancer is an emerging disease with an increase in prevalence of aggressive histotypes in recent years. Background: In the present study, potential histopathological and immunohistochemical prognostic markers were investigated. Consecutive cases of high-grade non-endometrioid carcinoma (HG-NEC) of the endometrium were considered. Methods: Each surgical specimen was routinely processed; the most significant block was selected for immunohistochemistry and tested for ER, PR, ki67, p53, E-cadherin, \u03b2-catenin, Bcl-2 and cyclin D1. For each immunomarker, the percentage of positive tumor cells was evaluated (%) and dichotomized as low and high according to the distribution in the study population. Follow-up was collected for disease-free survival (DFS) and overall survival (OS). Thirty-three cases were eligible: 19 resulted in FIGO I\u2013II; 14 resulted in FIGO III\u2013IV. Twelve patients suffered a recurrent disease (mean follow-up 24.6 months); 8 patients died of the disease (mean follow-up 26.6 months). Results: Women with recurrent disease demonstrated a significantly higher Bcl2% (35.84 \u00b1 30.96% vs. 8.09 \u00b1 11.56%; p = 0.0032) while DOD patients had higher ki67% (75 \u00b1 13.09% vs. 58.6 \u00b1 19.97%; p = 0.033) and Bcl2% of border significance (34.37 \u00b1 34.99% vs. 13 \u00b1 17.97%; p = 0.078). As expected, FIGO III\u2013IV had a worse DFS (HR = 3.34; 95% CI: 1.1\u201310.99; p = 0.034) and OS (HR = 5.19; 95% CI: 1.27\u201321.14; p = 0.0217). Bcl-2-high patients (Bcl2 &gt; 10%) demonstrated a significantly worse DFS (HR = 9.11; 95% CI: 2.6\u201332.4; p = 0.0006) and OS (HR = 7.63; 95% CI: 1.7\u201334; p = 0.0084); moreover, PR low patients (PR \u2264 10%) had significantly worse DFS (HR = 3.74; 95% CI: 1.2\u201311.9; p = 0.02). Conclusions: HG-NEC represents a heterogeneous group of endometrial aggressive neoplasms with a worrisome prognosis, often at an advanced stage at presentation. Bcl-2 and PR may represent promising markers to identify a subgroup of patients having an even worse prognosis requiring a careful and close follow-up.<\/jats:p>","DOI":"10.3390\/diagnostics13132171","type":"journal-article","created":{"date-parts":[[2023,6,27]],"date-time":"2023-06-27T01:49:21Z","timestamp":1687830561000},"page":"2171","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Histopathological and Immunohistochemical Prognostic Factors in High-Grade Non-Endometrioid Carcinomas of the Endometrium (HG-NECs): Is It Possible to Identify Subgroups at Increased Risk?"],"prefix":"10.3390","volume":"13","author":[{"given":"Michele","family":"Paudice","sequence":"first","affiliation":[{"name":"Department of Integrated Diagnostic and Surgical Sciences (DISC), University of Genoa, 16100 Genoa, Italy"},{"name":"Pathology University Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara Maria","family":"Biatta","sequence":"additional","affiliation":[{"name":"Anatomy and Pathological Histology, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Scaglione","sequence":"additional","affiliation":[{"name":"Pathology Unit, Fondazione Policlinico A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Parodi","sequence":"additional","affiliation":[{"name":"Department of Integrated Diagnostic and Surgical Sciences (DISC), University of Genoa, 16100 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6560-0061","authenticated-orcid":false,"given":"Serafina","family":"Mammoliti","sequence":"additional","affiliation":[{"name":"Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melita","family":"Moioli","sequence":"additional","affiliation":[{"name":"Obstetrics & Gynecology University Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Grazia","family":"Centurioni","sequence":"additional","affiliation":[{"name":"Obstetrics & Gynecology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4117-6603","authenticated-orcid":false,"given":"Fabio","family":"Barra","sequence":"additional","affiliation":[{"name":"Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2225-5568","authenticated-orcid":false,"given":"Simone","family":"Ferrero","sequence":"additional","affiliation":[{"name":"Obstetrics & Gynecology University Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"},{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"De Cian","sequence":"additional","affiliation":[{"name":"Department of Integrated Diagnostic and Surgical Sciences (DISC), University of Genoa, 16100 Genoa, Italy"},{"name":"General Surgery University Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6599-5681","authenticated-orcid":false,"given":"Katia","family":"Mazzocco","sequence":"additional","affiliation":[{"name":"Pathology Unit, IRCCS Istituto Giannina Gaslini, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5107-1584","authenticated-orcid":false,"given":"Valerio Gaetano","family":"Vellone","sequence":"additional","affiliation":[{"name":"Department of Integrated Diagnostic and Surgical Sciences (DISC), University of Genoa, 16100 Genoa, Italy"},{"name":"Pathology Unit, IRCCS Istituto Giannina Gaslini, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,26]]},"reference":[{"key":"ref_1","unstructured":"Stewart, B.W., and Wild, C.P. 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