OCT4, Ki-67 and VEGF as Prognostic Factors in Endometrial Carcinoma and Their Role in The Differentiation between Atypical Endometrial Hyperplasia and Grade 1 Endometrial Carcinoma: an Immunohistochemical study

Document Type : Original Article


1 Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt

2 Pathology Department, Armed Forces College of Medicine, Egypt.


Background: Endometrial carcinoma develops through preliminary stages of endometrial hyperplasia. A population of epithelial stem cells was identified in the human endometrium, these cells may serve as a source of putative endometrial carcinoma. The most important member of cancer stem cell markers is OCT-4. Both tumor cell proliferation (Ki-67) and angiogenesis seem to be important for the development of aggressive tumors. Aim of the Work: This study aimed to evaluate the expression of OCT4, Ki-67 and VEGF in endometrial hyperplasia and endometrial carcinoma and to differentiate between grade 1 endometrial carcinoma and atypical endometrial hyperplasia. Materials and Methods: 60 cases of endometrial hyperplasia and 60 cases of endometrial carcinoma were stained by OCT4, Ki-67and VEGF immunohistochemical markers. Results: OCT-4 expression was significantly increased with advanced tumor grade and stage (P value = 0.001, 0.044) respectively. There was also significant association between Ki-67 expression and advanced tumor grade and stage (P value = 0.0016, 0.049) respectively. VEGF expression was significantly increased with advanced tumor grade and stage (P value = 0.001) for both. As regards the correlation of immunohistochemical results between atypical endometrial hyperplasia versus grade 1 endometrial carcinoma cases, Ki-67 was the marker with significant relation. Conclusion: OCT-4, Ki-67 and VEGF expressions showed a positive correlation with tumor aggressive pathological parameters. The Ki-67 labelling index can be used in differentiation between endometrial hyperplasia with atypia and grade 1 endometrial carcinoma.


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