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Analytical Cellular Pathology
Volume 33, Issue 5-6, Pages 245-255

High Frequency Microsatellite Instability Has a Prognostic Value in Endometrial Endometrioid Adenocarcinoma, But Only in FIGO Stage 1 Cases

Anita Steinbakk,1,2,3 Anais Malpica,4 Aida Slewa,1 Einar Gudlaugsson,1,3 Emiel A. M. Janssen,1 Mark Arends,5 Arnold Jan Kruse,6 Yu Yinhua,7 Weiwei Feng,8 and Jan P. Baak1,3

1Department of Pathology, Stavanger University Hospital, Stavanger, Norway
2Department of Gynaecology, Stavanger University Hospital, Stavanger, Norway
3The Gade Institute, University of Bergen, Bergen, Norway
4Departments of Pathology and Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
5Department of Pathology, Addenbrooke’s Hospital, University of Cambridge, Cambridge, England
6Department of Gynecology, Academic Medical Center, Maastricht, The Netherlands
7Department of Experimental Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
8Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China

Copyright © 2010 Hindawi Publishing Corporation and the authors. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objectives: To analyze the prognostic value of microsatellite instability (MSI) in a population-based study of FIGO stage 1–4 endometrial endometrioid adenocarcinomas.

Study Design: Survival analysis in 273 patients of MSI status and clinico-pathologic features. Using a highly sensitive pentaplex polymerase chain reaction to establish MSI status, cases were divided into microsatellite stable (MSS), MSI-low (MSI-L, 1 marker positive) and MSI-high (MSI-H, 2–5 markers positive).

Results: After 61 months median follow-up (1-209), 34 (12.5%) of the patients developed metastases but only 6.4% of the FIGO 1. MSI (especially as MSI-H vs. MSS/MSI-Lcombined) was prognostic in FIGO 1 but not in FIGO 2–4. The 5 and 10 year recurrence-free survival rates were 98% and 95% in the MSS/MSI-L vs. 85% and 73% in the MSI-H patients (p=0.005).

Conclusions: MSI-H status assessed by pentaplex polymerase chain reaction is an indicator of poor prognosis in FIGO 1, but not in FIGO 2–4 endometrial endometrioid adenocarcinomas.