Leptin expression in stromal cells of endometrial carcinomas is associated with advanced stage and disease recurrence

Mohamad Nidal Khabaz, Nadeem Shafique Butt, Basim Al-Maghrabi, Nisrin Anfinan, Khalid Sait, Jaudah Al-Maghrabi

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Abstract

This study investigates the relation between leptin expression and the clinicopathological parameters in endometrial carcinomas. Seventy-one cases of previously diagnosed endometrial carcinoma (including 59 endometrioid adenocarcinomas, 9 serous carcinomas, 1 clear cell adenocarcinoma, and 2 malignant mixed Mullerian tumors) and 30 tissue samples of non-cancerous endometrium (including 16 proliferative endometrium, 10 secretory endometrium and 4 endometrial polyps) were employed for leptin detection using tissue microarrays and immunostaining. A total number of 48 (67.6%) cases were positive for leptin immunostaining. Brown granular cytoplasmic expression of leptin was detected in almost 68% of endometrioid adenocarcinomas, 66.7% serous carcinomas. Twenty-one (70%) control cases showed granular cytoplasmic expression. Positive leptin immunostaining was found more frequent in transformed epithelial cells and stromal cells of endometrioid adenocarcinomas and serous carcinomas respectively, showing significant statistical association (P-value = 0.005). Tumor stage is also significantly associated with cell type leptin immunoreactivity (P-value = 0.007), a considerable fraction of stage II is associated with leptin immunostaining of transformed epithelium whereas leptin immunoreactivity in endometrial stromal cells is more frequent in stage III. Disease recurrence rate is significantly higher in patients whom endometrial stromal cells are positive for leptin immunostaining (P-value = 0.000). Poor survival status (death) is also significantly associated with a group of patients whom endometrial stromal cells showed positive leptin immunoreactivity (P-value = 0.000). Our results confirm the diagnostic and prognostic values of leptin in supporting the diagnosis and prognosis of endometrial carcinomas. These preliminary findings recommend that leptin may be a valuable marker for predicting histotype, stage, recurrence and poor prognosis in endometrial carcinoma.

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